tci General Surgery Coding Alert - 2023 Issue Q1

You Be the Coder: Clip This Handy ‘Prolonged Service’ Chart

Question: I’m very confused by the change to prolonged service coding for 2023. Could you please simplify and clarify how to use the new codes and rules? Michigan Subscriber Answer: The situation is confusing with different sets of codes and rules for Medicare and private payers. Key: For all payers, you add a prolonged service code when you’re reporting the evaluation and management (E/M) service based on time, and the provider has reached a specific time threshold. The difference is that CMS prolonged service codes kick in once the procedure goes 15 minutes beyond the maximum time...

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