Prolonged Services


Boston, MA
Best answers
Hello - I have a peculiar scenario:

Can prolonged services in the inpatient setting be carried over to the next date?
An example: The physician sees the patient in the inpatient setting at 9:00pm on Day 1 and stays with the patient to monitor the condition and provide the necessary care until
1:30am on day 2. Lets say the E/M is a Level 3 subsequent visit (99233) which has 35 minutes typical time.
How would we bill the time after midnight AND where can I find something in writing - preferably from Medicare - on this topic?
Does the prolonged service carry over with the Day 1 DOS, do we start with a new E/M at midnight, should we just forget about it? Any guidance is greatly appreciated!

Thank you very much!
Milwaukee WI
Best answers
New DOS New E/M

E/M services are billed by DOS. Once you cross midnight a new E/M service begins.

Everything, per usual, depends on the documentation.

I'm wondering if it is medically necessary to remain at the patient's bedside from 9:00p to 1:30 am the next day ... could this be critical care?

I just can't imagine the medical necessity of this kind of prolonged service ... especially in an inpatient setting ... unless the patient is critically ill.

Hope that helps.

F Tessa Bartels, CPC, CEMC