How do I use CPT code 99354?

Prolonged physician services (CPT code 99354) in the office or other outpatient setting with direct face-to-face patient contact which require one hour beyond the usual service are payable when billed on the same day by the same physician or qualified nonphysician practitioner (NPP) as the companion evaluation and …

Can 99354 be used with 90837?

Procedure code 99354 can only be used in conjunction with procedure code 90837 and can only be used once an additional 30 minutes of services are provided. (The first 1–29 additional minutes beyond the initial 60 minutes are not separately reimbursable per CPT guidelines.)

Does CPT code 99354 need a modifier?

Yes. They claim that 99354 and 96365 cannot be billed together without a modifier.

Is CPT 99354 an add on code?

CPT Code 99354 is a prolonged service CPT code add-on. It cannot be billed alone and must be billed with an appropriate procedure code.

What is procedure code 99215?

evaluation and management
The CPT evaluation and management (E/M) code 99215, “Office or other outpatient visit for an established patient,” is rarely used, accounting for about 5 percent of E/M visits.

How many minutes is a 99215?

40-54 mins
Time

What is the primary code for CPT 99354?

Procedure codes

What modifier is used with 99354?

modifier 25
May a physician or other qualified health care professional report prolonged services (CPT codes 99354- 99357) with modifier 25 when a significant and separately identifiable E/M service is performed along with a separate service or procedure?

Does 99215 need a modifier?

If an established patient office visit (99211 – 99215) is done in conjunction with any service listed in the Surgery section of CPT (codes 10041 – 69990), and the office visit service meets criteria for the use of modifier codes 24, 25 or 57, the appropriate modifier should be appended to the office visit code.

Who can bill CPT code 99215?

CPT Code 99215 Description CPT Code 99215: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a high level of medical decision making.

What is a 99215 CPT code?

The CPT evaluation and management (E/M) code 99215, “Office or other outpatient visit for an established patient,” is rarely used, accounting for about 5 percent of E/M visits.

Does CPT 99215 need a modifier?

You may be wondering if you can use a modifier with procedure code 99215. You may use the modifier -21 if your appointment is longer than 40 minutes. Because 99215 is the longest E/M code for established patients (40 minutes), modifier -21 will allow you to bill for extra time.