ED Coding & Reimbursement Alert - 2022 Issue 4
Prolonged Services: Boost Non-Face-to-Face Service Claims With Comprehensive Documentation
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Article Overview
This article reviews how prolonged service time is addressed in CPT and Medicare-related office and outpatient evaluation and management billing. It is aimed at coding professionals and clinicians who document chart review, record analysis, communications, and other non-face-to-face work, with attention to timing, payer differences, and documentation support.
Why This Topic Matters
Accurate handling of prolonged service time can affect whether non-face-to-face work is captured on a claim and whether the documentation supports payment. The article helps readers understand the broad compliance and documentation issues involved in this category of reporting.
Article Sections
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Tip: Know the specifics on provider/patient communication
Introduces the article’s focus on communication-related documentation and the role of non-face-to-face work in reporting.
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Don’t Use 99358/+99359 Attached to 99202-99215
Discusses one category of prolonged service reporting and its relationship to office and other outpatient evaluation and management visits.
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Avoid +99417/G2212 Unless the Time Is Attached to a Same-Day 99202-99215
Covers another prolonged service reporting approach tied to office or outpatient evaluation and management time on the same day.
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Document This Work Before Using 99358/+99359
Focuses on documentation support, timing, and general categories of activities relevant to prolonged non-face-to-face work.
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Don’t Try to Double Dip for 99358/+99359
Addresses overlap concerns with other services and the need to avoid counting time that is already reported elsewhere.
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Look to 99358/+99359 for Non-Face-to-Face Longer Than 31 Minutes
Summarizes the article’s discussion of time thresholds and prolonged non-face-to-face reporting.
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Watch Units to Avoid Claim Delays
Notes unit-count considerations and includes a brief payer reminder related to reimbursement policies.
What You Will Learn
- How prolonged non-face-to-face work is discussed in relation to office and outpatient evaluation and management reporting
- What kinds of documentation support are emphasized for chart review, record analysis, and related communication
- How time thresholds and same-day considerations are presented for prolonged service reporting
- Why payer-specific policies may differ from general coding guidance
Who Should Read This
- Medical coders
- Billers
- Physicians
- Qualified health care professionals
- Practice managers
Codes Discussed
Code Ranges Discussed
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