2018 Revisions to Prolonged Services

January 18th, 2018 - Wyn Staheli, Director of Research

Categories: CPT^® Coding

For 2018, there were some changes to the guidelines for prolonged services (99358 and 99359). Providers need to be aware that there were technical corrections made which may not be included in their CPT code book - but they are in FindACode.com effective January 1, 2018. Please note that the AMA publishes corrections to their code book throughout the year and FindACode.com is always updated as these changes are made available so you don't have to worry about having the correct information.

Please note the following technical changes (highlighted text is new per the official addenda, green text is new as in 2018 book, strikeout text is removed):

2017 Description: Prolonged service of less than 30 minutes total duration on a given date is not separately reported.

2018 CPT(R) Book: Prolonged service of less than 30 minutes total duration on a given date is not separately reported.

2018 Addenda: Prolonged service of less than 30 minutes total duration on a given date is not separately reported because the work involved is included in the total work of the evaluation and management or psychotherapy codes.

This technical correction shows what change was supposed to be included in the 2018 CPT code book with the explanation of WHY they should not be separately reported.

The next correction is found at the end of the guidelines for that section of the book:

2017 Description: Do not report 99358, 99359 for time spent in care plan oversight services (99339, 99340, 99374-99380), anticoagulant management (99363, 99364), medical team conferences (99366-99368), on-line medical evaluations (99444), or other non-face-to-face services that have more specific codes and no upper time limit in the CPT code set. Codes 99358, 99359 may be reported when related to other non-face-to-face services codes that have a published maximum time (eg, telephone services).

2018 CPT(R) Book: Do not report 99358, 99359 for time spent in care plan oversight services (99339, 99340, 99374-99380), anticoagulant management (99363, 99364), home and outpatient INR monitoring (93792, 93793), medical team conferences (99366-99368), on-line medical evaluations (99444), or other non-face-to-face services that have more specific codes and no upper time limit in the CPT code set. Codes 99358, 99359 may be reported when related to other non-face-to-face services codes that have a published maximum time (eg, telephone services).

2018 Addenda: Do not report 99358, 99359 for time spent in care plan oversight services (99339, 99340, 99374-99380), anticoagulant management (99363, 99364), home and outpatient INR monitoring (93792, 93793), medical team conferences (99366-99368), or on-line medical evaluations (99444)., or other non-face-to-face services that have more specific codes and no upper time limit in the CPT code set. Codes 99358, 99359 may be reported when related to other non-face-to-face services codes that have a published maximum time (eg, telephone services).

Again, this technical correction shows what it was supposed to be with the removal of references to non-face-to-face services. The first correction wasn't as significant of a change, however this correction is more critical as there are OTHER changes to non-face-to-face services and a coding example table was added. Telephone services were also updated and corrected.

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