Friday, March 16, 2012

CPT-4 Code 99357 & 99356 - Inpatient prolonged visit

CPT-4 Code 99357 To report prolonged inpatient E&M services, CPT-4 codes 99357 (each additional 30 minutes) must be billed in conjunction with code 99356.


Billing Calculations CPT-4 codes 99356 and 99357 are subject to the least restrictive frequency limitation as the required companion code. To calculate the amount of time that is payable for prolonged inpatient services, take the total unit/floor time and subtract the time of the primary E&M service. The following table may be used to calculate billing for prolonged inpatient E&M services.



Time of E&M visit code not included First hour Each additional 30 minutes

Less than 30 minutes Not reported Not reported

30 – 74 minutes 99356 Not reported

75 – 104 minutes 99356 99357

105 – 134 minutes 99356 99357 (quantity of 2)

135 – 164 minutes 99356 99357 (quantity of 3)

165 – 194 minutes 99356 99357 (quantity of 4)

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