Part B Insider (Multispecialty) Coding Alert
Prolonged Services
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Documentation of physician time is critical to charge for prolonged services (CPT 99354 for outpatient or 99356 for inpatient). Prolonged services are face to face, as is the E/M code for outpatient charges.In the inpatient environment, however, E/M codes are based on floor time (99221-99223, 99231-99233, 99251-99255, 99261-99263, and 99238-99239).So face-to-face time, when using prolonged services with inpatient E/M codes, must be at least 30 minutes.Total times needed to support prolonged services with each E/M code are listed above. Discharges: Prolonged service is not charged with discharge codes, but which code used is determined by the documented floor time. 99238 is for a discharge with documented floor time of 30 minutes or less. Emergency E/M codes: Do not use prolonged service codes with emergency E/M codes (99281-99285).If an admission follows an emergency department E/M, attach the prolonged service code to the admission. - Source:Barbara Cobuzzi, Cash Flow Solutions, Lakewood, N.J.
99239 is for a discharge with documented floor time of more than 30 minutes.
Part B Insider (Multispecialty) Coding Alert
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Prolonged Services
Documentation of physician time is critical to charge for prolonged services (CPT 99354 [...]