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https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM5972.pdf
service as noted in the CPT code. You should report each additional 30 minutes of direct face-to-face patient contact following the first hour of prolonged services with CPT code 99355. In the inpatient setting, Medicare will pay for prolonged physician services (code
https://www.aapc.com/blog/38738-hard-facts-of-coding-prolonged-services/
Jun 01, 2017 · When using time as the controlling factor for counseling and/or coordination of care, use the highest available E/M level first, ... 105 or more minutes beyond the CPT® code time = 99354 x 1 and 99355 x 2 (or more for each additional 30 minutes) ... 2 Responses to “Hard Facts of Coding Prolonged Services” Carol Pugh says:
https://www.supercoder.com/coding-newsletters/my-cardiology-coding-alert/reader-question-no-prolonged-services-with-discharge-codes-article
For a service to be considered prolonged, the amount of time spent providing care must exceed a set amount of time by at least 30 minutes. For example, if the cardiologist spends 90 minutes admitting a patient, the examination, history and decision-making performed warrant code 99222, which has a base time of 50 minutes.
https://thehappyhospitalist.blogspot.com/2009/09/how-to-bill-prolonged-service-codes-in.html
This contradicts the newer CPT® definitions of prolonged service codes. They have also stated that time spent in gathering information from the family or discussing the medical plan with family not in the presence of the patient does not count toward the use of prolonged care codes. I think this is a tragedy.
https://www.aapc.com/blog/31678-billing-prolonged-services-with-direct-patient-contact/
Prolonged services with direct patient contact are reported using CPT® codes 99354-99357. Prolonged services are add-on codes; you must report them with their companion evaluation and management (E/M) code. Prolonged services are time-based codes; therefore, time must be documented. This time does not need to be continuous.
https://quizlet.com/309980873/understanding-cpt-2-final-flash-cards/
Code the following: Routine obstetric care and vaginal delivery, previous cesarean delivery. ... Because of prolonged bleeding, the procedure took 65 minutes more than usual. The modifier that should be reported is _____. ... For each of the CPT codes listed state which section of CPT that the code would be located in. The correct answer is ...
https://www.supercoder.com/cpt-codes-range/1721
Lookup CPT® 59000-59899, Surgical Procedures for Maternity Care and Delivery, with CPT® code descriptor, lay term, and guidelines. Take a free trial for 14 days.
https://providers.bcbsal.org/portal/documents/10226/306297/Obstetrics+Coding+and+Documentation+Reference+Guide/8f5f1b65-1fd2-49a5-8708-6819a162098e?version=1.0
Obstetrics Coding and Documentation Reference Guide CPT Coding CPT defines maternity-related services as: 59400 Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care 59409 Vaginal delivery only (with or without episiotomy and/or forceps); 59410 Vaginal delivery only (with or without episiotomy and/or forceps ...
https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-reimbursement/COMM-Prolonged-Services-Policy.pdf
According to CPT and HCPCS, prolonged service codes 99354-99357, 99359, 99415-99416 and G0513-G0514 are considered add-on codes and should not be reported without the appropriate primary code. Prolonged services for labor and delivery are not separately reimbursable services. As described in American Congress
https://hospitalists.chfm.ufl.edu/files/2010/05/Prolonged-and-Critical-Care-Codes.pptx
Prolonged Care – When?CPT Codes 99354-99357. Used when time of required patient care exceeds normal time guidelines for E/M codes by at least 30 minutes. Cannot bill second code if <15minutes left after billing for first hour or if <15 minutes left beyond the …
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