Article Detail - JE Part B

Medical record reviews of Evaluation and Management (E/M) and prolonged services have identified an error when ketamine has been administered.

Do not bill a prolonged service code when ketamine has been administered and a medical professional supervises and monitors the patient for at least two hours to watch for any serious side effects. The prolonged office or other outpatient service code G2212, has been billed incorrectly for ketamine observation time.

The ketamine visit code description includes the E/M and the two-hour monitoring time.

• G2082 - Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg esketamine nasal self-administration, includes two-hours post-administration observation
• G2083 - Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes two-hours post-administration observation