You Be the Coder:
Process This CPT® 2012 Prolonged Care Revision
Published on Sat Jan 15, 2011
Question: I know the E/M codes for observation services changed, but I heard the prolonged services did too. Is that true?Virginia SubscriberAnswer: Yes. CPT® 2012 E/M code revisions clarify timeframes and providers for both observation services and prolonged care.Prolonged service: Codes +99354-+99359 delete "physician" and substitute "direct patient contact" for "face-to-face" requirements from the descriptors, which opens the door for other qualified health care professionals who have billing privileges in your practice to submit the codes when appropriate. For example, the new descriptor for +99354 will read: Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient E/M service). Direct patient contact still means a "face-to-face" service has been provided but also incorporates unit/floor time when appropriate.Observation times: Similarly, effective Jan. 1, 2012, each code for initial observation care (99218-99220) [...]