decisionhealth Newsletters, Part B News - 2017 Issue 2 (February)
Exert caution when reporting shared visits for prolonged care services
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Article Overview
This article reviews Medicare guidance affecting split/shared visits for prolonged care services. It focuses on how prolonged service reporting intersects with office and other E/M settings, documentation expectations, incident-to requirements, and the limits of applying shared-visit concepts to non-face-to-face prolonged services. The piece is aimed at coding and billing professionals, physicians, and non-physician practitioners who need to understand current policy context before reporting prolonged care.
Why This Topic Matters
Split/shared prolonged service reporting can affect whether a service is billable and which provider may report it. Understanding the Medicare policy framework helps practices avoid misreporting and documentation gaps for prolonged care encounters.
Article Sections
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Split/shared visits and prolonged care under Medicare
Introduces the topic of prolonged care in split/shared visits and frames the Medicare policy context for reporting these services in office and related settings.
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Policy and documentation considerations
Summarizes the documentation and timing themes discussed in the article, including how Medicare guidance informs reporting for prolonged services and shared encounters.
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Limits and uncertainty for non-face-to-face prolonged services
Addresses the article’s discussion of non-face-to-face prolonged service reporting and the uncertainty surrounding shared-visit application in that area.
What You Will Learn
- How Medicare split/shared visit policy relates to prolonged care services
- Which general settings and documentation issues are discussed for prolonged service reporting
- Why office-based and non-face-to-face prolonged services are treated differently in the article’s policy discussion
- What types of compliance concerns arise when more than one provider participates in a prolonged care encounter
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians
- Non-physician practitioners
Codes Discussed
Code Ranges Discussed
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