tci E/M Coding Alert - 2018 Issue 1

Reader Question: Bust This Prolonged Care Services Myth

Question: Can you report prolonged services with any level of E/M code or just the highest-level E/M codes? Alabama Subscriber Answer: It's a common myth that prolonged care services can only be reported with the highest level of E/M code, like 99205 (Office or other outpatient visit for the evaluation and management of a new patient...) or 99215 (...an established patient...) for office services. However, this is not true. You can report prolonged care codes +99354 (Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or...

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