The article Coding Brief: Prolonged Services Without Direct Patient Contact (p 13) of the January 2019 issue of CPT Assistant stated that [c]odes 99358 and 99359 may be used for physician or other QHP communication with the family that extends beyond the E/M service rendered on a given date. In a clinical scenario, a physician or other QHP initiates a telephone discussion with a patient on a different date than a E/M-related service. May code 99358 be reported when a physician or other QHP spends at least 30 minutes communicating on the telephone with a patient when a related E/M service has not occurred on the same day? ...
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Article Overview
This article reviews CPT Assistant guidance on prolonged services performed without direct patient contact and discusses how the CPT 2021 E/M framework addresses related communication and record-review situations. It is relevant to physicians, other qualified health care professionals, coders, and billing staff who need to understand the scope of prolonged service reporting and how telephone service categories are distinguished under CPT guidance. The article also notes that payer policy may differ from CPT coding guidance.
Why This Topic Matters
It helps readers determine whether a prolonged-service or telephone-service scenario falls within the scope of CPT Assistant and CPT codebook guidance, while also flagging that payer rules may vary.
Article Sections
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Coding Brief
Introduces the scenario and the coding question addressed in the brief.
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Prolonged Services Without Direct Patient Contact
Summarizes the CPT Assistant discussion of prolonged services and related E/M framework guidance.
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Telephone Services
Addresses the telephone-service subsection and its relationship to the scenario described in the article.
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Payer Policy Note
Mentions that third-party payer coverage and payment policies may differ from CPT guidance.
What You Will Learn
- How the article frames prolonged services without direct patient contact.
- How related CPT E/M guidance is discussed in the context of communication and ongoing patient management.
- How telephone service guidance is distinguished from physician-initiated calls.
- Why payer policy considerations may still need to be checked separately.
Who Should Read This
- Physicians
- Other qualified health care professionals
- Medical coders
- Billing staff
- Revenue cycle staff
Codes Discussed
Code Ranges Discussed
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