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99355

Changes in Prolonged Services Codes

Threshold Times for Codes 99354 and 99355 (Office or Other Outpatient Setting) If the total direct fact-to-face time equals or exceeds the threshold time for code 99354, but is less than the threshold time for code 99355, you should bill the E&M visit code and code 99354.

News Flash -- The NPI will be Required for all HIPAA Standard ...

To get to the threshold time for billing code 99354 and two units of code 99355, add 30 minutes to the threshold time for billing codes 99354 and 99355.

MM5972 job aid

Related MLN Matters Number: MM5972 CPT only copyright 2007 American Medical Association. All rights reserved. Page 2 of 5 • Providers should report each additional 30 minutes of direct face-to-face patient contact following the first hour of prolonged services by using CPT code 99355.

CMS: Revisions to Consultation Services Payment

Threshold Time for Prolonged Visit Codes 99354 and/or 99355 Billed with Office/Outpatient and Consultation Codes Code Typical Time for Code Threshold Time to Bill Code 99354 Threshold Time to Bill Codes 99354 and 99355 99201 10 40 85 99202 20 50 95 99203 30 60 105 99204 45 75 120 99205 60 90 135 99212 10 40 85 99213 15 45 90

In the Case of Klaes Chiropractic Clinic

DEPARTMENT OF HEALTH AND HUMAN SERVICES DEPARTMENTAL APPEALS BOARD DECISION OF MEDICARE APPEALS COUNCIL In the case of Claim for Klaes Chiropractic Clinic, Supplementary Medical Inc. Insurance Benefits (Part B) (Appellant) **** **** (Beneficiary) (HIC Number) National Government Services, Inc ...

AAOS in the States

codes with office visits built into their relat ive value units (RVU) by .03%. We have also created a Microsoft excel program which providers can use to calcul ate the fiscal impact on their practices as a result of this change.

Prolonged Physician Services (With Direct Face-to-Face Contact)

If the total direct face-to-face time equals or exceeds the threshold time for code 99355 by no more than 29 minutes, the physician should bill the visit code 99354 and one unit of code 99355. One additional unit of code 99355 is billed for each additional increment of 30 minutes extended duration.

Pediatric Obesity Coding

Pediatric Obesity Coding CPT Evaluation and Management Codes Complexity New Consults (MD referred only) Initial Visit Returns Prolonged Physician Service Recheck/re-evaluate Care Plan Oversight (Once/month) 1 (lowest) 99241 99201 99211 99354X1 99374 2 99242 99243 99202 99203 99212 99213 99354X1 ...

Bulletin Number: xxxxxx

Threshold Times for Codes 99354 and 99355 (Office or Other Outpatient Setting) If the total direct face-to-face time equals or exceeds the threshold time for code 99354, but is less than the threshold time for code 99355, you should bill the E&M visit code and code 99354.

Article 1 - Prolonged Service Codes

1 of 1 Article 1 9/22/2007 Prolonged Service Codes By billing with codes 99354 and 99355, your practice may be able to take advantage of additional reimbursement for the extra time you spend with your patients.