Currently we bill complicated labor management time (outside of global) using the primary E&M Code and then the prolonged care codes 99354 (or 99356 depending on POS) and 99355 (or 99357) per date of service. I have read in several different places that prolonged care should be billed continuously if there is no break in the care - in other words, don't start over with the primary E&M code on the next DOS. This would lead me to believe that you would bill, for instance, 99232, 99356 and 99375 all on the date of service that the prolonged care started even if it went into the next calendar date. Per the CPT Code book, these prolonged care codes are to be used by date of service so I am conflicted. Does anyone have any specific knowledge about the correct way to bill this prolonged care time?