News You Can Use: Check-In on This Prolonged Services Update

Why This Topic Matters

Prolonged service reporting changed for 2023, and the article helps readers understand how the AMA and Medicare diverge so claims can be coded consistently with the applicable payer rules.

Article Sections

1. Know the Updated +99417 Definition

   Covers the 2023 update to an AMA prolonged services CPT code and the related guidance for outpatient evaluation and management reporting. It explains the broader context of time-based prolonged service billing changes.

2. Beware +99417 CPT® Updates

   Summarizes expanded CPT prolonged service guidance and the types of evaluation and management settings affected for 2023. The section discusses the overall scope of revised CPT reporting conventions.

3. Don’t Forget to Use G Codes for Medicare

   Describes Medicare’s separate prolonged services approach and the introduction of replacement HCPCS G-codes. It highlights how Medicare policy differs from the AMA framework for certain time-based services.

4. Consider This Clinical Scenario

   Provides a brief case-based comparison of AMA and Medicare application in an inpatient setting. The section is intended to illustrate the contrast between payer rules without substituting for the full guidance.