tci General Surgery Coding Alert - 2022 Issue Q1

Reader Questions: Watch the Minutes for E/M Prolonged Services

Question: Documentation for a new patient office E/M service shows high-complexity medical decision making (MDM) and time of 87 minutes. Should we report this using the prolonged service code? Minnesota Subscriber Answer: No, the visit you describe doesn’t call for a prolonged service code. To use the prolonged service add-on code for a new patient office evaluation and management (E/M) service, you must document the maximum time for the highest level E/M office code plus at least an additional 15 minutes. That would be 74 minutes plus 15 minutes for a total of 89 minutes, which would warrant...

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