decisionhealth Newsletters, Answer Books - 2011 Issue 5 (May)
Prolonged Services / Non face-to-face codes (99358, 99359)
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Article Overview
This article explains the CPT framework for prolonged physician services performed without direct patient contact and discusses how these services are positioned relative to evaluation and management care. It also notes a CMS change affecting billing to Medicare and summarizes the CPT guidance and example context used to distinguish these services from other non-face-to-face reporting categories. The article is aimed at medical coders, billers, and compliance staff who need a general understanding of when this CPT topic is addressed and how it fits within broader reporting guidance.
Why This Topic Matters
Prolonged services can affect evaluation and management reporting, date-of-service handling, and Medicare billing considerations, so understanding the CPT guidance helps reduce reporting errors and denials.
Article Sections
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Overview of prolonged non-face-to-face services
Introduces the CPT topic and the setting in which prolonged physician services without direct patient contact are discussed. It also notes the Medicare-related update mentioned in the article.
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Reporting guidance and timing considerations
Summarizes the general CPT guidance on how these services are described in relation to time, date of service, and broader evaluation and management care. This section also distinguishes the topic from other non-face-to-face services addressed in CPT.
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CPT Assistant example
Presents an illustrative scenario from CPT Assistant showing the type of prolonged service context discussed in the article. The example is used to frame the article’s subject matter without substituting for the original guidance.
What You Will Learn
- How CPT describes prolonged physician services without direct patient contact
- How the article frames timing and reporting context for this CPT topic
- How CMS changes affected the ability to bill the services to Medicare
- How CPT distinguishes this topic from other non-face-to-face service categories
- How the article uses a CPT Assistant example to illustrate the subject
Who Should Read This
- Medical coders
- Medical billers
- Coding auditors
- Compliance staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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