tci ED Coding & Reimbursement Alert - 2002 Issue 6

Reader Question: Prolonged Services in ED

Question: How should our ED physician receive reimbursement when patients are kept in the ED while they are waiting to be transferred to another facility? During this time, we continue to monitor patients. Should we report prolonged services codes for these cases? Washington SubscriberAnswer: No, that would be incorrect. Prolonged services codes (+99354, Prolonged physician service in the office or other outpatient setting requiring direct [face-to-face] patient contact beyond the usual service [e.g. prolonged care and treatment of an acute asthmatic patient in an outpatient setting]; first hour [list separately in addition to code for office or other...

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