Time Is of the Essence With Prolonged Service Codes

Why This Topic Matters

The article helps practices recognize where documentation and claim setup problems commonly occur so they can better align billing with Medicare Part B review expectations.

Article Sections

1. Prolonged Services Often Misbilled

   This section addresses documentation and timing concerns associated with prolonged evaluation and management services discussed by the contractor. It also references a webinar and a sample scenario involving office visit timing.

2. NGS Focuses on Chiropractic Errors

   This section summarizes recurring chiropractic claim issues, including diagnosis sequencing, medical necessity documentation, and Medicare coverage context. It also references payer guidance and a historical CMS transmittal.

3. Keep an Eye on Medical Necessity for Labs

   This section reviews common documentation shortcomings for diagnostic laboratory services and emphasizes requisition and ordering information. It includes general examples of how test purpose and supporting diagnoses may be recorded.