decisionhealth Newsletters, Answer Books - 2017 Issue 1 (January)
Prolonged Services / Service must be provided face-to-face (office) or unit/floor (inpatient)
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Article Overview
This article explains general guidance for prolonged E/M service reporting across office, outpatient, inpatient, nursing facility, and related settings. It is aimed at coding professionals who need to understand the scope of prolonged service billing, documentation expectations, and the types of companion E/M services referenced by CMS. The discussion centers on timing, setting, and the distinction between face-to-face and non-face-to-face prolonged services.
Why This Topic Matters
Prolonged services can affect whether an E/M service is reported correctly and whether related time-based work is considered separately or bundled. Understanding the article helps coders and billers apply the general framework consistently across the settings and code groups referenced by CMS.
What You Will Learn
- Which care settings are discussed in relation to prolonged E/M services
- How prolonged service time thresholds are framed in the article
- What documentation elements are highlighted for office-based prolonged service reporting
- Which broad categories of E/M services are referenced as companion codes
- How the article distinguishes face-to-face and non-face-to-face prolonged services
Who Should Read This
- Medical coders
- Billers
- Revenue cycle staff
- Compliance staff
- Physician practices
- Hospital coding professionals
Codes Discussed
Code Ranges Discussed
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