tci Part B Insider - 2021 Issue Q4

Part B Coding Coach: Boost Prolonged Services Savvy With These Expert Tips

Warning: Don’t add prolonged service codes to service levels calculated by MDM. If you find navigating CPT® prolonged services challenging, you’re not alone. In fact, many coders have struggled with coding and billing prolonged services since Medicare introduced a new code in the 2021 fee schedule. Read on for more background information and an expert’s take on what to do. Reminder: Last December, the Centers for Medicare & Medicaid Services’ (CMS) published the 2021 Medicare Physician Fee Schedule (MPFS) in the Federal Register, creating a whole set of headaches for medical billers and coders. Their disagreement...

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