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August 21, 2019

Prolonged Services (CPT Codes 99354 – 99359)

During recent CERT (Comprehensive Error Rate Testing) reviews CGS is seeing errors involving the documentation of time for the prolonged services and would like to remind you of the following documentation requirements.

"…Documentation is required to be in the medical record about the duration and content of the medically necessary evaluation and management service and prolonged services that you bill.

You MUST appropriately and sufficiently document in the medical record that you personally furnished the direct face-to-face time with the patient specified in the CPT code definitions. Make sure that you document the start and end times of the visit, along with the date of service."

The above information can be found in the MLN Matters Article # MM5972 Prolonged ServicesExternal PDF

Be sure to review the above publication to ensure proper coding of Prolonged Services.

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