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Prolonged Service

  1. #1
    Default Prolonged Service
    Medical Coding Books
    My provider saw a patient and spent 45 minutes with the patient regarding her disease process, management and H&P to update record. Afterwards she spend approximate 90 minutes doing chart review, review of consults/old records/testing and hospital reports to update the clinical note. Her question is can she bill an E/M and also a Prolong Code?
    Thanks for your help

  2. #2
    Everett, WA
    Here's my take, and hopefully those who are more qualified to answer will step in. I think this is a case for upcoding the EM based on the documentation elements. In other words 45 minutes would qualify it for a 99215 established patient time based EM assignment based on counseling and coordination of care and the non-face to face Prolonged Service Codes could ALSO be added, but documentation must be concise and detailed. Those prolonged service codes can be a pain to get paid and it's all in the documentation. We're always required to file chart notes and be prepared to appeal . However, the revenue makes it worth pursuing. ---Suzanne E. Byrum CPC

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