tci Medicare Compliance & Reimbursement - 2008 Issue 37

Prolonged Services: Simple Steps To Bill Prolonged Services Without Modifier 21

3 steps help you keep your pay despite CPT's deletions. If you're used to adding modifier 21 to E/M codes to capture additional reimbursement when your physician spends longer than normal with a patient, now's the time to revamp your coding. CPT 2009 deletes modifier 21 (Prolonged evaluation and management services) effective Jan. 1, directing you to look instead at the prolonged service codes (+99354-+99357). Here's the scoop on what you'll need to know to avoid denials come Jan. 1.Rejoice In More Specific Coding In the past, you've been able to append modifier 21 to the highest level...

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