Wiki Cpt coding

[RSoldat]

does anyone use 99358 and 99359 for billing and do you have some tips. I have never used them and my providers are asking for documentation requirements.

 

[csperoni]

My recommendation - don't do it

When I started working for one of my docs, he insisted on coding 99358 for almost every new consult for reviewing the previous records.
1) The record needs to state exactly how much time was spent and exactly what was reviewed. 99358 requires at least 31 minutes. (really - how many docs are spending more than 1/2 hour to review a patient's records before the patient even comes in??)
2) Very few carriers pay for the service, even when submitting documentation and appeals.
3) Two carriers flagged us as "upcoders" for using this code, and for years, then required us to submit documentation for all services even when not billing 99358.
I did an analysis of the number of times we billed the code and the total payments. It averaged to $7.99. It was clearly not work the additional documentation requirements, billing requirements, appeal letters and getting flagged.
-Christine M. Speroni, CPC