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Prolonged service(s) in the outpatient setting requiring direct patient contact beyond the time of the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)

CPT4 code

Name of the Procedure:

Prolonged service(s) in the outpatient setting requiring direct patient contact beyond the time of the usual service; each additional 30 minutes

Summary

This procedure involves providing extended care for an outpatient that exceeds the standard time for a typical service. Each additional unit represents 30 minutes of extra direct patient contact.

Purpose

Prolonged services address situations where complex medical conditions require more time for evaluation, management, and treatment than usual appointments allow. The goal is to ensure comprehensive patient care and thorough assessment.

Indications

  • Chronic illnesses requiring detailed and extended evaluation
  • Complex medical conditions that necessitate prolonged counseling or coordination
  • In-depth discussions about treatment plans or prognosis
  • Patients with multiple comorbidities that need comprehensive review

Preparation

Typically, no special preparation is needed. However:

  • Bring all relevant medical records and lists of current medications.
  • Patients may need to complete specific forms or surveys prior to their appointment.

Procedure Description

  1. Initial Evaluation: The patient is assessed based on their medical condition.
  2. Extended Consultation: The healthcare provider spends additional time beyond the standard appointment doing a detailed review, discussing management plans, or providing counseling.
  3. Documentation: Extra time is documented to ensure it meets the criteria for prolongation.

Tools used include standard medical documents, evaluation tools, and sometimes electronic health records (EHR) systems.

Duration

Each unit signifies an additional 30 minutes beyond the usual service time. The total duration varies depending on the patient's needs.

Setting

Typically performed in outpatient clinics, medical offices, or other outpatient settings.

Personnel

  • Primary care physicians or specialists
  • Nurses
  • Medical assistants

Risks and Complications

The risks associated with prolonged services are minor but include:

  • Potential for increased patient fatigue due to longer consultations
  • Possible delays for other scheduled patients

Benefits

  • More thorough and detailed patient evaluation and management
  • Better illness management due to comprehensive planning
  • Improved patient outcomes through meticulous care

Recovery

No specific recovery period is required. Patients can resume their normal activities immediately after the consultation. Follow-up appointments may be scheduled as needed.

Alternatives

  • Standard appointment times with multiple follow-up visits
  • Group consultations, when applicable
  • Online or telehealth consultations for follow-up care

Each alternative comes with different accessibility, time efficiency, and cost considerations.

Patient Experience

Patients might feel more engaged and understood due to the extended time spent. They may experience some fatigue or information overload, but reassurance and follow-up instructions are provided to mitigate this. Pain management or comfort measures are generally not needed.

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