tci Part B Insider - 2014 Issue 40

Physician Notes: This MAC Highlights the Most Common Prolonged Service Errors

Remember to bill each add-on code with its companion code. Reporting prolonged service codes +99354-99357 can help you maximize your reimbursement for longer than usual E/M visits, but one MAC recently found that not all providers are clear on how to bill these codes. NGS Medicare released the results of its recent audits of prolonged service codes, which noted that on average, a startling 88.7 percent of prolonged service claims were reduced or denied after auditors reviewed the documentation. In fact, only 8.5 percent of the claims that the MAC reviewed for dates of service in Sept...

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