Prolonged Services in medical billing and coding

We will get confuse for Prolonged coding.

While going to code Prolonged service, We must receive documentation from the provider by mentioning of Duration.
 
Duration is very important to code Prolonged service. Prolonged codes are 99354,99355 (Out Patient) and 99356,99357(Inpatient).

When ever find that duration in the Medical Record.  We need to calculate Time and Which Prolonged codes need to add.

Rules:

Duration :

• 30 Minutes we can go with E/M only
• 30 minutes and<74 99354="" 99356="" and="" can="" code="" in="" li="" minutes="" nbsp="" out="" pt="" visit="" we=""> 
• 75 minutes and<104 99354="" 99355="" 99356="" amp="" and="" can="" code="" li="" minutes="" we=""> 
• 105 minutes 99354*1& 99355*2

After Duration of the E/M, We can code Prolonged Services

Eg: A endocrinologist confirms a est patient that a lesion, biopsied a few days before, is malignant. the provider spends 110 min checking non-surgical and surgical methods with the patient. That visit considered as counseling and coordination of care. To charge this visit depended on duration.

 According E/M guidelines level is going to high as 99215.

According to Duration table; 99215 had taken 40 minutes but total visit duration 110 minutes.