4 ways to fool-proof billing for prolonged services

Why This Topic Matters

Prolonged services are a frequent source of denials, so understanding the article can help readers assess whether their billing and documentation processes align with payer expectations.

Article Sections

1. Prolonged service denials and billing trends

   Introduces denial trends and the broader billing problem surrounding prolonged services. Sets up the areas of guidance discussed in the article.

2. Understand the time thresholds

   Explains the first major area of concern involving time-based billing and how prolonged services relate to the typical time for E/M visits.

3. Face-time vs. indirect contact

   Covers the distinction between direct patient contact and record review or other indirect work, including the related CPT update and payer considerations.

4. Consults, counseling and prolonged services

   Discusses prolonged service issues that arise when counseling time affects E/M selection and when consult-like scenarios are converted to other visit types.

5. Document times with relentless accuracy

   Focuses on documentation expectations for time-based services and the importance of recording visit times accurately.