tci Part B Insider - 2003 Issue 10

CHART: Prolonged Services

Documentation of physician time is critical to charge for prolonged services (CPT 99354 for outpatient or 99356 for inpatient). Prolonged services are face to face, as is the E/M code for outpatient charges.In the inpatient environment, however, E/M codes are based on floor time (99221-99223, 99231-99233, 99251-99255, 99261-99263, and 99238-99239).So face-to-face time, when using prolonged services with inpatient E/M codes, must be at least 30 minutes.Total times needed to support prolonged services with each E/M code are listed above.   Discharges: Prolonged service is not charged with discharge codes, but which code used is determined by...

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