April 2012 page 10
Coding Clarification: Administration/Monitoring of Oral Multiple Sclerosis Treatment Therapy
We have received questions about whether the prolonged services evaluation and management (E/M) codes (99354 and 99355) may be reported when providing extended office or other outpatient vital signs monitoring services associated with the oral administration of fingolimod, a disease modifying therapy, for long-term treatment of relapsing subtypes of multiple sclerosis in adults. Although the protocol for administration of this drug may require prolonged monitoring of the patient's vital signs (eg, every 30 to 60 minutes for up to 6 hours) to assess bradycardia following oral...
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