tci ED Coding & Reimbursement Alert - 2001 Issue 4

Reader Question: Prolonged Services

Question: Are prolonged service codes 99354 and 99355 billable in the ED setting?Indiana SubscriberAnswer: No, because the prolonged service guidelines state that the service must have exceeded 30 minutes beyond the usual time for the E/M service. ED E/M codes (99281-99285) do not have a time associated with them. Therefore, you cannot determine when prolonged time starts if the ED E/M is an unidentified time frame. ...

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