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Primary Care Coding Alert

Reader Question:

Prolonged E/M is no Longer Restrictive to Physician Services

Published on Mon May 14, 2012

Question: How can we report prolonged face-to-face E/M services provided by our physician in 2012 given the change in descriptor for codes 99354 and 99355?

New Jersey Subscriber

Answer: Prolonged services with direct patient contact have add-on codes that you report with the appropriate E/M service codes. When your family physician spends at least 30 minutes or more time beyond the typical time for a particular E/M code, you will report prolonged services in the outpatient setting or office with +99354 (Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour [List separately in addition to code for office or other outpatient Evaluation and Management service]) for the first hour (actually, 30-74 minutes) of prolonged service. You can report every additional 30 minutes of direct patient contact with +99355 (Prolonged service in the office or [...]
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