decisionhealth Newsletters, Answer Books - 2011 Issue 5 (May)
Prolonged Services / Use one of these handy threshold time tables from the Medicare Claims Processing Manual
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Article Overview
This article provides a Medicare Claims Processing Manual reference on prolonged services threshold time tables. It is aimed at coding professionals who need a quick way to review which visit families are covered, how the tables are organized, and what general timing guidance is included for prolonged service billing across outpatient and inpatient settings.
Why This Topic Matters
Prolonged services timing references can affect accurate code selection and documentation review. This article helps readers find the relevant Medicare table for the visit setting they are coding and understand the scope of the manual-based guidance presented.
Article Sections
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Threshold Time for Prolonged Visit Codes 99354 and/or 99355 Billed with Office/Outpatient and Consultation Codes
A Medicare timing table organized by office, outpatient, consultation, and related visit code families. It presents the threshold-time reference format used for prolonged service billing in these settings.
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Threshold Time for Prolonged Visit Codes 99356 and/or 99357 Billed with Inpatient Setting Codes
A second Medicare timing table organized for inpatient and related facility visit code families. It provides the corresponding threshold-time reference format for prolonged service billing in these settings.
What You Will Learn
- How the article organizes Medicare prolonged services threshold time references
- Which visit code families are included in the outpatient and inpatient timing tables
- What general types of manual-based prolonged service guidance are summarized
- How the article distinguishes timing references by care setting
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Compliance staff
- Physician practice administrators
Codes Discussed
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