# Extended ER Services



## Kristene (Feb 16, 2016)

Would like to get some feedback on what different facilities are doing with patients who need extended emergency room services. Is there a potential charge for this extended time? Or do you use Observation code? 

Appreciate any feedback for this situation! 
Kris


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## jimbo1231 (Feb 17, 2016)

*Extended services*

Kris,

Prolonged service codes would make the most sense but unfortunately do not apply to ED POS. the Teasoning behind it which I always found odd was that since ED codes have no time component you can't have an add on code with a time component. Observation codes are an option but the documentation must support admission to observation. simply being in the ED a long time doesn't establish medical necessity for Obs codes. The other option is the 99284/5 which have no time component but sometimes involve fairly lengthy treatments.  And CC is the patient is very sick and time is documented. And if patients are in the ED a long time due to admission bottlenecks that is a patient flow problem not a coding issue

Jim


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