99357 Prolonged service in the inpatient or observation setting, requiring unit/floor time beyond the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)

Name of the Procedure:

Prolonged Service in the Inpatient or Observation Setting, Requiring Unit/Floor Time Beyond the Usual Service; Each Additional 30 Minutes (CPT Code: 99356, 99357)

Summary

Prolonged service in the inpatient or observation setting refers to the additional time healthcare providers spend attending to a patient beyond the usual service time. This may include reviewing results, coordinating care, or directly interacting with the patient, and is billed in 30-minute increments.

Purpose

This procedure ensures that patients who require more extensive care than usual receive adequate attention and medical intervention. It aims to address complex medical conditions that necessitate prolonged monitoring and treatment.

Indications

• Complicated medical cases requiring extended evaluation and management
• Multisystem disease processes needing intricate care coordination
• Patients presenting with severe or life-threatening conditions

Preparation

• Ensure all prior diagnostic tests and assessments are readily available for review.
• Patients should provide a comprehensive medical history and list of current medications.

Procedure Description

1. The healthcare provider spends additional time beyond the usual service on the patient’s care.
2. Activities include detailed review of medical records, consultations with specialists, and in-depth patient evaluation.
3. Continuous monitoring and ongoing adjustments to the patient's treatment plan are performed.
4. Use of standard medical equipment and patient monitoring tools.
5. No specific anesthesia or sedation is applied, unless the primary medical condition requires it.

Duration

Each increment of prolonged service is 30 minutes.

Setting

Typically performed in a hospital inpatient unit or a designated observation area.

Personnel

• Primary physician
• Nurses
• Specialists (as needed)
• Other healthcare practitioners involved in the patient's care plan

Risks and Complications

• Minimal risks directly associated with the prolonged service itself
• Complications may arise due to the primary medical condition being treated
• Ensuring thorough documentation to avoid any miscommunication

Benefits

• Enhanced and thorough medical care
• Improved patient outcomes due to meticulous monitoring and timely interventions
• Potentially faster recovery due to comprehensive care

Recovery

• Post-procedure, the patient continues to receive regular care according to their primary medical condition.
• Follow-up appointments and continuous monitoring might be necessary based on the initial reason for prolonged service.

Alternatives

• Standard inpatient or observation services without additional extended time
• Outpatient follow-up visits or telehealth consultations

Patient Experience

• Patients can expect more frequent visits from the healthcare team.
• There may be ongoing assessments and continuous monitoring.
• Pain management and comfort measures will be provided as needed to ensure patient well-being.