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Prolonged Services

  1. #1
    Default Prolonged Services
    Medical Coding Books
    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!
    Karolina, CPC, CPMA, CEMC

  2. #2
    Milwaukee WI
    Default 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

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