nursing home visits

What is the right way to bill a nursing home visit that is a prolonged visit? I have billed 99310 with 99354. Medicare pays 99310 but denies 99354. They say "not covered when performed during during the same session /date as a previously submitted claim. Both were billed for dos 11/07/2011.

re: nursing home visits

A nursing home visit is an INPATIENT setting, code 99354 is outpatient.
In the inpatient setting, Medicare will pay for prolonged physician services (code
99356) (with direct face-to-face patient contact which require one hour beyond the
usual service), when billed on the same day by the same physician or qualified
NPP as the companion evaluation and management codes. You should report
each additional 30 minutes of direct face-to-face patient contact following the first
hour of prolonged services may be reported by CPT® code 99357.