08/15/2023

ASCO Coding Tip of the Month: August 2023

When an evaluation and management level of service is based on time and the total time is over that of the maximum time indicated in the description of the service, prolonged service codes may be reported. AMA CPT guidelines allow prolonged services to be reported once the maximum required time of the primary service has been exceeded. CMS instructs 15 minutes beyond the total time of the primary service must be met to report any prolonged services.

Office and outpatient: 99417, G2212
Non-office and outpatient: 99418, G0316 (Hospital inpatient and observation), G0317 (Nursing facility), G0318 (Home or residence)

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