prolong service

I have a medicare patient. My doctor wants prolonged service for her round at the hospital. This patient has severe aortic stenosis. How would you code this?

re: prolong service

Refer to this handy guide: http://thehappyhospitalist.blogspot.com/2009/09/how-to-bill-prolonged-service-codes-in.html

Remember that prolonged service codes are considered add-ons, so a qualifying E&M service should be billed first; and always make sure the documentation supports the billing of prolonged services, more than likely it will have to go to medical review before it gets paid.

re: prolong service

In reading medicare guidelines do you think that the initial round 99231-99233 should be done also by the physician requesting the prolonged service since the review of records is not included in the 99356 or 99357. My coworker and I was debating this since guidelines says same physician. My thought was that it should be same Dr.

re: prolong service

Yes, it would have to be the same doctor since a different physician would bill a separate, qualifying E&M service first. Here is an MLN document on the topic: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/mm5972.pdf

Make sure the physician documents and goes beyond the threshold of time (30 minutes beyond the E&M) in order to correctly bill for the prolonged services. The pdf above has a time table to reference.