tci Part B Insider - 2003 Issue 11

Coding: Add Prolonged Services to Applicable E/M Only

If you're billing for prolonged service codes 99354-99357, you should be careful to avoid adding them to the wrong codes. You can't add prolonged service codes to hospital observation (99217-99220), observation or inpatient care (including admission and discharge services) (99234-99236), critical care (99291-99292), or emergency department services (99281-99285), says Tara Conklin, coding specialist at Clark-Holder Clinic in LaGrange, Ga.Time isn't considered a factor in determining the level of care for those codes, so adding prolonged services codes to them won't win you any favors, Conklin says. Or in the case of critical care, time is already the...

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