Evaluation and Management (E/M): Prolonged Physician Service Without Direct (Face-To-Face) Patient Contact
Guidelines have be revised to clarify that prolonged services without direct (face-to-face) patient contact codes are to be reported for prolonged services that are beyond the usual non-face-to-face component of the physician service time. Also, the add-on status has been removed from code 99358, which helps clarify that the prolonged services (99358 and 99359) may now be reported on a different date than the primary service to which it is related.
However, the guidelines specify that the prolonged service must relate to a service or patient where direct face-to-face patient care has occurred or will occur and relate to ongoing patient management. The primary service to which the prolonged service is related does not need to have a typical time established in the CPT code set. Additional language states that 99358 should be used only once per date.
The new guidelines make it clear that codes 99358 and 99359 should not be reported for time spent in medical team conferences, on-line medical evaluations, care plan oversight services, anticoagulation management, or other non face-to-face services that have more specific codes and no upper time limit in the CPT code set. However, when related to other non-face-to-face services that have a published maximum time (eg, telephone services), codes 99358, 99359 may be reported.
With the removal of the add-on code status from 99358, the descriptors of codes 99358 and 99359 were revised with the deletion of the standard add-on code language. The examples of prolonged services were also removed from codes 99358 and 99359.
99358 Prolonged evaluation and management service before and/or after direct (face-to-
face) patient care; first hour
+99359 each additional 30 minutes (List separately in addition to code for prolonged
physician service)
http://www.acog.org/departments/dept_notice.cfm?recno=6&bulletin=4990