Part B Insider (Multispecialty) Coding Alert
Prolonged Services
Documentation of physician time is critical to charge for prolonged services (CPT 99354 for outpatient or 99356 for inpatient). Prolonged services are face to face, as is the E/M code for outpatient charges.In the inpatient environment, however, E/M codes are based on floor time (99221-99223, 99231-99233, 99251-99255, 99261-99263, and 99238-99239).So face-to-face time, when using prolonged services with inpatient E/M codes, must be at least 30 minutes.Total times needed to support prolonged services with each E/M code are listed above. Discharges: Prolonged service is not charged with discharge codes, but which code used is determined by the documented floor time. 99238 is for a discharge with documented floor time of 30 minutes or less. Emergency E/M codes: Do not use prolonged service codes with emergency E/M codes (99281-99285).If an admission follows an emergency department E/M, attach the prolonged service code to the admission. - Source:Barbara Cobuzzi, Cash Flow Solutions, Lakewood, N.J.
99239 is for a discharge with documented floor time of more than 30 minutes.
Part B Insider (Multispecialty) Coding Alert
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Prolonged Services
Documentation of physician time is critical to charge for prolonged services (CPT 99354 [...]
