Using CPT Code 99354 in Your Medical Practice
Posted on April 13, 2010 | No Comments
Adam Alpers asked:
Using the proper CPT codes for patient billing is crucial if you want to avoid delays in receiving payment from your patients’ insurance providers. However, there are some medical professionals who do not bill for time that they could actually be compensated for. This is largely due to a lack of understanding of Code 99354. This code is used for prolonged physician services in an outpatient setting, although not all doctors bill for this time even though they are rightfully entitled to.
CPT Code 99354 is defined as a prolonged physician service provided in the office or other outpatient setting that requires direct, face-to-face patient contact beyond customary and usual services for the first hour. This code must be listed separately, in addition to the code for the office or other outpatient evaluation and management service. The average reimbursement amount for this code is ninety-five dollars, depending on the region in which you provide your services.
According to the Medicare Manual, a doctor must document the start and end times of each office visit along with the date of the visit. When using CPT Code 99354, it is important to remember that only the doctor’s time is considered. The time spent by staff does not count and can not be billed under this code. If you, as the treating physician, are spending more time than usual with a patient and wish to be compensated for that time, using Code 99354 is a must.
Why Isn’t Code 99354 Used More Often?
CPT Code 99354 is one of the most under-utilized CPT code in most medical practices. The reasons for this vary, but one of the best ways to ensure that you are putting this code to work for you is by properly documenting any prolonged time spent with each of your patients.
If you are spending unusual amounts of face-to-face time with a particular patient, you should be paid for your time and using this code will ensure that happens. You just need to make sure that you are documenting the time properly. If you spend just a little more time documenting the time you spend with your patients, you can be compensated for extra time spent rather than not being paid for the full extent of your services.
Not All Patients Are Created Equal
Not all patients are the same and it is only natural that some patients will require more time than others. If you have seriously ill patients in your office and you spend a significant amount of time helping these individuals, you should be using CPT Code 99354 when billing for the services you provide.
As a general rule, if you are spending more than 40 minutes with a particular patient and the circumstances meet all of the necessary criteria, you can bill the CPT code associated with the patient’s primary care and treatment. If, however, you end up spending any additional time with this patient, then the additional time can be compensated using CPT Code 99354. You just need to be sure that the time is recorded properly.
Keeping Accurate Records
When billing a patient’s insurance using CPT Code 99354, make sure that you record the start and end times of the patient’s visits as well as the total amount of face-to-face time spent with the patient. Accurate records are essential to the success of your billing and compensation, especially if you want to be paid for all time spent with the patients you treat.
Documenting the Intensity of Care
It is not uncommon for physicians to leave the room while a patient is undergoing a treatment to spend time with another patient. Make sure that you accurately document the time you actually spend with the patient up until the point you leave the room. Once you return to the patient, start the clock again. For example, if you leave the room to provide a patient with a nebulizer treatment and then return to the room to discuss how the patient feels, begin documenting the time that you returned to the room and how long you stayed with the patient. If you have to leave and return again, the clock begins once again.
While you can bill for the initial time spent with a patient under the proper CPT code, the extra time spent with the patient can be billed under CPT Code 99354. This ensures that you are compensated for the extra time you spend with patients who need more time than usual in order for you to care for them properly.
A Right to Compensation
If you are spending an unusual amount of time with a single patient, you deserve to be compensated for that time. This is why the CPT 99354 exists. You owe it to yourself and your practice to maximize your revenue. Unfortunately, many providers do not make use of this code and remain unpaid for extra time spent with the patients they serve. The fact of the matter is, if you perform the work and properly document your time, you can (and should) bill for the extra time you spend with your patients using code CPT 99354.
Kansieo.com
Using the proper CPT codes for patient billing is crucial if you want to avoid delays in receiving payment from your patients’ insurance providers. However, there are some medical professionals who do not bill for time that they could actually be compensated for. This is largely due to a lack of understanding of Code 99354. This code is used for prolonged physician services in an outpatient setting, although not all doctors bill for this time even though they are rightfully entitled to.
CPT Code 99354 is defined as a prolonged physician service provided in the office or other outpatient setting that requires direct, face-to-face patient contact beyond customary and usual services for the first hour. This code must be listed separately, in addition to the code for the office or other outpatient evaluation and management service. The average reimbursement amount for this code is ninety-five dollars, depending on the region in which you provide your services.
According to the Medicare Manual, a doctor must document the start and end times of each office visit along with the date of the visit. When using CPT Code 99354, it is important to remember that only the doctor’s time is considered. The time spent by staff does not count and can not be billed under this code. If you, as the treating physician, are spending more time than usual with a patient and wish to be compensated for that time, using Code 99354 is a must.
Why Isn’t Code 99354 Used More Often?
CPT Code 99354 is one of the most under-utilized CPT code in most medical practices. The reasons for this vary, but one of the best ways to ensure that you are putting this code to work for you is by properly documenting any prolonged time spent with each of your patients.
If you are spending unusual amounts of face-to-face time with a particular patient, you should be paid for your time and using this code will ensure that happens. You just need to make sure that you are documenting the time properly. If you spend just a little more time documenting the time you spend with your patients, you can be compensated for extra time spent rather than not being paid for the full extent of your services.
Not All Patients Are Created Equal
Not all patients are the same and it is only natural that some patients will require more time than others. If you have seriously ill patients in your office and you spend a significant amount of time helping these individuals, you should be using CPT Code 99354 when billing for the services you provide.
As a general rule, if you are spending more than 40 minutes with a particular patient and the circumstances meet all of the necessary criteria, you can bill the CPT code associated with the patient’s primary care and treatment. If, however, you end up spending any additional time with this patient, then the additional time can be compensated using CPT Code 99354. You just need to be sure that the time is recorded properly.
Keeping Accurate Records
When billing a patient’s insurance using CPT Code 99354, make sure that you record the start and end times of the patient’s visits as well as the total amount of face-to-face time spent with the patient. Accurate records are essential to the success of your billing and compensation, especially if you want to be paid for all time spent with the patients you treat.
Documenting the Intensity of Care
It is not uncommon for physicians to leave the room while a patient is undergoing a treatment to spend time with another patient. Make sure that you accurately document the time you actually spend with the patient up until the point you leave the room. Once you return to the patient, start the clock again. For example, if you leave the room to provide a patient with a nebulizer treatment and then return to the room to discuss how the patient feels, begin documenting the time that you returned to the room and how long you stayed with the patient. If you have to leave and return again, the clock begins once again.
While you can bill for the initial time spent with a patient under the proper CPT code, the extra time spent with the patient can be billed under CPT Code 99354. This ensures that you are compensated for the extra time you spend with patients who need more time than usual in order for you to care for them properly.
A Right to Compensation
If you are spending an unusual amount of time with a single patient, you deserve to be compensated for that time. This is why the CPT 99354 exists. You owe it to yourself and your practice to maximize your revenue. Unfortunately, many providers do not make use of this code and remain unpaid for extra time spent with the patients they serve. The fact of the matter is, if you perform the work and properly document your time, you can (and should) bill for the extra time you spend with your patients using code CPT 99354.
Kansieo.com