decisionhealth Newsletters, Part B News - 2018 Issue 3 (March)
Without face-to-face visit, you’re stuck holding the bag on prolonged care
Subscribe or sign in to view the full article.
Article Overview
This Part B News article examines coding guidance for prolonged services in situations where no face-to-face visit took place, including telephone communication, delayed or missed encounters, and related non-face-to-face time. It is relevant to physicians, office-based practices, coders, and billing staff who need to understand the general scope of prolonged service reporting and how it relates to other E/M and care management services. The article also touches on Medicare billing edits and documentation considerations without providing a substitute for the full coding guidance.
Why This Topic Matters
It helps practices determine whether a prolonged-service claim may be relevant when the anticipated office visit does not happen and highlights the need to align non-face-to-face work with an appropriate related encounter.
Article Sections
-
Ask Part B News
An introductory reader Q&A format presenting the billing scenarios covered in the article.
-
Question 1: Telephone contact and prolonged services
A scenario involving a lengthy telephone conversation and whether any billable service may apply in the absence of an in-person visit.
-
Question 2: Planned visit that does not occur
A question about whether non-face-to-face prolonged services remain billable when the related visit is canceled or missed.
-
Answer
A discussion of the general billing framework for non-face-to-face prolonged services, related encounter timing, and related care management considerations.
What You Will Learn
- How the article frames prolonged-service questions when no face-to-face visit occurs
- What general billing relationships are discussed between prolonged services and related E/M encounters
- Why missed or canceled visits matter in the context of non-face-to-face time
- How the article connects prolonged services with chronic care management at a high level
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Outpatient practice administrators
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com