AMA CPT® Assistant - 2009 Issue 7 (July)
Revisions to Prolonged Services (Codes 99354-99357) (July 2009)
July 2009 pages 8-9 Revisions to Prolonged Services (Codes 99354-99357) For CPT 2009, revisions were made to the Prolonged Physician Service codes and the guidelines for reporting these codes, in order to further clarify the reporting of these services. This article provides an overview of these revisions. Revised Guidelines The guidelines for codes 99354-99357 for face-to-face outpatient and inpatient prolonged services have been revised. The new guidelines state, "This service is reported in addition to the designated evaluation and management (E/M) services at any level and any other physician services provided at the same session as evaluation and management...
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Article Overview
This article explains July 2009 CPT guidance updates for prolonged physician services. It is aimed at coders and billers working with evaluation and management services, time-based add-on reporting, parenthetical code instructions, and related questions about when prolonged services apply in office, inpatient, nursing facility, and psychotherapy settings. The piece also summarizes a deleted modifier and includes Q&A clarifications from CPT Assistant.
Why This Topic Matters
Revisions to prolonged service reporting can affect how evaluation and management encounters are documented and coded across multiple care settings. Understanding the update helps coding staff apply the current CPT guidance and recognize which related codes and parenthetical instructions were changed.
Article Sections
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July 2009 pages 8-9
Publication and issue information for the CPT Assistant article.
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Revised Guidelines
General changes to prolonged service reporting guidance for office/outpatient and inpatient settings, including discussion of time-based reporting and related E/M context.
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Example (Code 99354)
A narrative example illustrating prolonged service reporting in an outpatient setting.
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Total Duration of Prolonged Services
A timing summary showing how prolonged service duration is grouped for reporting purposes.
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Revisions to Parenthetical Instructions
Updates to parenthetical notes tying prolonged service codes to related evaluation, management, and psychotherapy code families.
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Deletion of Modifier 21
Discussion of the removal of a modifier previously used for prolonged evaluation and management services.
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Question and Answers
CPT Assistant Q&A clarifications addressing prolonged service reporting in different clinical and setting contexts.
What You Will Learn
- How CPT revised its guidance for prolonged physician services in 2009
- Which care settings and service types the article addresses
- How parenthetical instructions were updated for related code families
- What issue prompted removal of a previously used modifier
- What kinds of reporting questions were clarified in the article's Q&A section
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Physician practices
- Hospital coding departments
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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