tci E/M Coding Alert - 2021 Issue Q3

Prolonged Services: Add One More Step to Your Billing Workflow to Appease CMS

Hint: You cannot add prolonged service codes to service levels calculated by medical decision making. You know prolonged service coding got extra wonky in December 2020, when the Center for Medicare & Medicaid Services (CMS) published the Physician Fee Schedule (PFS). You were left trying to navigate the CPT® prolonged services as well as the CMS created code. Are you still struggling with coding and billing prolonged services? Read on for more background information and an expert’s take on what to do. Background: The Centers for Medicare & Medicaid Services’ (CMS’) published the 2021 Physician Fee Schedule...

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