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Observation billing and prolonged care

  1. #1
    Default Observation billing and prolonged care
    Medical Coding Books
    Hello and Happy New Year,

    Can you bill prolonged care with these codes? CPT lists the codes you can use, but does not include the prolonged care 99218-20 and 99234-36. I am trying to bill the outpatient prolonged care.
    I quickly checked NCCI and E&M billing guidelines. I feel if you could, this would be cited in CPT. Maybe I have overlooked.


  2. #2
    Columbia, MO
    No you may not append prolonged time to these codes. There is no way to upcode these from the level met by the documentation as there is no timed component to these codes.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Yes, you are correct. As soon as I read your response I realized that no time is associated with these codes. Thanks so much for such a quick response.

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