Part B Insider - 2023 Issue 3
You Be the Coder: Clip This Handy ‘Prolonged Service’ Chart
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Article Overview
This article reviews the 2023 changes affecting prolonged service reporting for evaluation and management services. It is aimed at coders and billing staff who need to understand how Medicare and other payers differ, what general timing framework applies, and why consultation-based reporting remains an issue under Medicare policy.
Why This Topic Matters
Accurate prolonged service reporting depends on payer-specific rules and timing thresholds, so misunderstandings can affect claim accuracy and compliance.
What You Will Learn
- How the 2023 prolonged service coding update affects time-based E/M reporting
- How Medicare guidance differs from private payer approaches
- Why payer policy matters when prolonged service reporting is considered
- How the article frames the use of a chart to understand timing thresholds
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle professionals
Codes Discussed
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