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99483 with 99358

Can anyone tell me if it’s acceptable to bill 99483 (assessment of and care planning for a patient with cognitive impairment) with 99358 (Prolonged e&m service, non direct)? I have a provider who is insisting this is ok, when they are using the prolonged service portion to complete the paperwork, etc. for the 99483. Any thoughts?:confused::cool:

Medical Billing and Coding Forum

CPT Codes 99358 & 99359 – Who may report?

Which types of providers may report CPT codes 99358 & 99359, Prolonged Services Without Direct Patient Contact?

Are these codes reserved for Physicians, NPs, PAs, etc. or can they be used by Clinical Social Workers and Clinical Psychologists?

If they can be used by Clinical Social Workers and Clinical Psychologists, would it be appropriate to use in conjunction with CPT Codes 98966-98968 for prolonged telephone services provided directly to a patient?

Thanks.

Medical Billing and Coding Forum

cpt codes 99358 & 99359 prolong codes-are you double dipping

• If a provider reviews extensive records on the SAME DATE OF SERVICE as an associated E/M service, and if we are going to bill 99358, would we still be able to credit the ‘review and summarization of old records’ on the medical decision making portion of the E/M service, or would this be considered ‘double-dipping’. I would ask the same question with the review being on a separate date of service. How do we make sure there is no double dipping

Medical Billing and Coding Forum

99358 Again

Today I find an article on AAPC regarding Medicare will pay for 99358.

https://www.aapc.com/blog/37804-cms-covers-99358-99359-prolonged-service/

CMS Now Covers 99358, +99359 Prolonged Services

Worker’s Comp also covers it.
1. Prolonged Service codes – non-face-to-face time – CPT codes 99358 and 99359 have been restored as billable codes. Their Billing Status in the fee schedule has changed to “A” – a billable code. Many orthopaedic practices used these codes to bill non face-to-face time for review of records. Medicare realized that the value of this additional work was not included in the value of the E&M services and they restored providers’ ability to bill these codes and in the update, DWC is following suit. It is important to remember the CPT definition of these codes:
99358 – Prolonged evaluation and management service before and/or after direct patient care, first hour.
99359 – each additional 30 minutes
It is not required that the time be continuous or spent all on the same day, however, prolonged service of less than 30 minutes total duration on a given date is not separately reported. Previously DWC had allowed the billing of these codes in 15 minute increments. Physicians will need to document the time spent in their reports. It is unclear whether DWC will also allow physicians to bill for the report. COA has asked DWC to clarify this point.

Per above 2 documents, Medicare and WC will both cover it except other commercial carriers.

Blackhorse, CPC-A

Medical Billing and Coding Forum

CMS Now Covers 99358, +99359 Prolonged Services

The Centers for Medicare & Medicaid Services (CMS) typically does not allow separate payment for physician services that do not require face-to-face time with a patient. As of Jan. 1, 2017, CMS has made an exception and will now allow Medicare coverage for non face-to-face prolonged service codes 99358 Prolonged evaluation and management service before […]
AAPC Knowledge Center