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Wiki Non face-to-face encounter 99358?
- Thread starter cyarberry
- Start date
sullivak
Guru
Well, on the surface, it appears you can code 99358 in this case. Per 2013 CPT, "This prolonged service may be reported on a different date than the primary service to which it is related."
However, according to the E&M Service Guidelines section of CPT, in the office setting face-to-face "is defined as only that time spent face-to-face with the patient and/or family." This, unfortunately, implies that you would need to use the Prolonged Service With Direct Patient Contact codes (99354-99355). However, those codes can only be reported on the same date as the original E/M.
It looks like this scenario cannot be coded. Anyone else have thoughts on this?
That's a tough case!
However, according to the E&M Service Guidelines section of CPT, in the office setting face-to-face "is defined as only that time spent face-to-face with the patient and/or family." This, unfortunately, implies that you would need to use the Prolonged Service With Direct Patient Contact codes (99354-99355). However, those codes can only be reported on the same date as the original E/M.
It looks like this scenario cannot be coded. Anyone else have thoughts on this?
That's a tough case!
nyyankees
True Blue
Hmmmm
Does counseling & coordination of care come into play?
Well, on the surface, it appears you can code 99358 in this case. Per 2013 CPT, "This prolonged service may be reported on a different date than the primary service to which it is related."
However, according to the E&M Service Guidelines section of CPT, in the office setting face-to-face "is defined as only that time spent face-to-face with the patient and/or family." This, unfortunately, implies that you would need to use the Prolonged Service With Direct Patient Contact codes (99354-99355). However, those codes can only be reported on the same date as the original E/M.
It looks like this scenario cannot be coded. Anyone else have thoughts on this?
That's a tough case!
Does counseling & coordination of care come into play?
lec1408@msn.com
New
lcampbell
99215 states "40 min spent face-to-face w/ patient "and/or" family. As long as the components of patient hx and MDM are met, would this code be appropriate?
99215 states "40 min spent face-to-face w/ patient "and/or" family. As long as the components of patient hx and MDM are met, would this code be appropriate?
lec1408@msn.com
New
lcampbell
...but was the discussion face-to-face or via phone? If via phone, wouldn't 9943 be appropriate?
...but was the discussion face-to-face or via phone? If via phone, wouldn't 9943 be appropriate?
sullivak
Guru
It would not be appropriate to code 99215 for the physician's speaking with a family member. This does not constitute another patient visit. The actual office visit was on a different DOS.
Regarding counseling and coordination of care - I can see the precedent in using counseling and coordination of care to allow the 99358. It's disappointing that this specific issue was not addressed in CPT Assistant.
Regarding counseling and coordination of care - I can see the precedent in using counseling and coordination of care to allow the 99358. It's disappointing that this specific issue was not addressed in CPT Assistant.