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ED Coding and Reimbursement Alert

E/M Coding:

Capture Prolonged Service Encounters in the ED With These Tactics

Published on Tue Aug 23, 2011

Tip: Read the fine print before assigning code 99354.A frequent question among emergency department coders is how to capture ED visits that extended longer than the average visit. Although you may be tempted to report the prolonged service add-on codes, such as 99354 (Prolonged physician service in the office or other outpatient setting requiring direct [face-to-face] patient contact beyond the usual service; first hour [List separately in addition to code for office or other outpatient Evaluation and Management service]), those codes are not available for use with ED E/M codes. Follow our advice below to recoup all appropriate reimbursement for all your prolonged services encounters.Get Up to Speed on The ChangesNew language in CPT® for 2011 states, "Intraservice times are defined as face-to-face time for office and other outpatient visits and as unit/floor time for hospital and other inpatient visits. This distinction is necessary because most of the work of [...]
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