BC Advantage - 2021 Issue 3

How to Properly Report Prolonged Services Using 99417 or G2212

Prolonged Evaluation & Management codes underwent big changes in 2021, including the creation of a new prolonged code (99417), reportable only with codes 99205 or 99215. While Medicare has agreed to accept the AMA's CPT E/M coding changes, they have formulated an opinion contrary to how CPT calculates time specific to reporting this prolonged service code, and have created a separate HCPCS code (G2212) for reporting prolonged services specific to 99205 and 99215. This warrants a quick review of the guidelines and criteria required for reporting this prolonged E/M service, as follows: Prolonged Codes Specific to 99205 and...

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