tci E/M Coding Alert - 2017 Issue 10

Reader Question: Avoid Reporting Prolonged E/M Services in ED

Question: Can we code for prolonged E/M services in the ED? Florida Subscriber Answer: No. You may not report prolonged services codes (99354-99357) with emergency department (ED) evaluation and management (E/M) codes (99281-99285) as these codes do not have an associated time assigned. However, if an ED E/M service becomes "prolonged," you might be able to code it as an observation visit instead, with the following codes, depending upon the encounter specifics: 99218 (Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components: a detailed or comprehensive history; a...

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