Wiki 99354-prolonged service

[jackiems]

Is anyone utilizing this cpt code in their practice along with the normal ov e/m codes? Some of our docs have begun to use it and now some patients
are getting a bill for two copays. Which of course they are disputing ( and I agree ) . Our docs are documenting the time in order to bill for it but how are your docs/office handling this? I would think that one of the co-pays would get written off because its like double dipping.
Thanks

 

[Tonyj]

Is anyone utilizing this cpt code in their practice along with the normal ov e/m codes? Some of our docs have begun to use it and now some patients
are getting a bill for two copays. Which of course they are disputing ( and I agree ) . Our docs are documenting the time in order to bill for it but how are your docs/office handling this? I would think that one of the co-pays would get written off because its like double dipping.
Thanks

The prolonged service code just shows that the physician spent more than the usual time with his/her patient, for a specific documented reason, on the same encounter day, face to face, with at least 50% of the time spent in counseling and/or coordinating care. Therefore, there would not be a separate copay. You're just informing the insurance company that you spent x amount of time on this patient and expect to be compensated for it.

 

[rebec26@juno.com]

Did you find anything else out about this? We have recently started using99354 and have the same problem with 2 co pays. Plus, we are also wondering if the time has to be documented with a start and stop time. Thanks!