southbaymed
Guest
The 3 year New Patient(61 year old male) w/back & neck sprain, headache, tinnitus, and head
injury brought the hospital report to show. Physician spent total 2 hours. To evaluate the
condition, he had to go through the hospital report precisely.
He charged 99205 & 99354.
Blue Cross denied: Prolonged physician attendance CPT99354 cannot be allowed separate
payment, since it is considered a service that is unbundled from another E/M.
Prolonged service is prolonged service which was necessary and actually the physician
spent while examining the patient and should be compensated....we believe.
BX said the determinations in the UM guideline. How about the time physician spent
to be charged to the patient?
We appreciate any constructive comment.
Thankyou
injury brought the hospital report to show. Physician spent total 2 hours. To evaluate the
condition, he had to go through the hospital report precisely.
He charged 99205 & 99354.
Blue Cross denied: Prolonged physician attendance CPT99354 cannot be allowed separate
payment, since it is considered a service that is unbundled from another E/M.
Prolonged service is prolonged service which was necessary and actually the physician
spent while examining the patient and should be compensated....we believe.
BX said the determinations in the UM guideline. How about the time physician spent
to be charged to the patient?
We appreciate any constructive comment.
Thankyou