Name of the Procedure:

Prolonged Evaluation and Management Service Before and/or After Direct Patient Care; Each Additional 30 Minutes (List Separately in Addition to Code for Prolonged Service)

Summary

This procedure involves additional time spent by healthcare practitioners in evaluating and managing a patient's condition before and/or after direct patient care. It is supplementary to the standard evaluation and management services and is billed in additional 30-minute increments.

Purpose

The primary purpose is to provide comprehensive evaluation and management for complex or time-intensive cases, ensuring thorough attention to the patient's medical needs beyond the standard consultation time.

Indications

• Complex medical conditions requiring extensive review and planning.
• Patients with multiple comorbidities needing detailed management.
• Situations necessitating prolonged discussions or coordinated care.

Preparation

• No special preparation is typically required from the patient.
• A detailed medical history and relevant diagnostic data should be available for review.

Procedure Description

1. Initial Assessment: The healthcare provider conducts an initial patient assessment.
2. Extended Evaluation: Additional time is spent reviewing the patient's medical history, diagnostic tests, and any previous treatments.
3. Management Planning: Development of a detailed treatment plan or adjustment of existing plans.
4. Coordination of Care: Communication with other healthcare providers, if necessary, to ensure cohesive care.

Tools typically include the patient's medical records, diagnostic reports, and communication devices (phone, email) to consult with other specialists.

Duration

Each additional increment involves 30 minutes of prolonged service.

Setting

This service can be performed in various settings, including hospitals, outpatient clinics, and private practices.

Personnel

Involves the primary healthcare provider (e.g., physician, nurse practitioner) and potentially other specialists for coordinated care.

Risks and Complications

• Generally low risk, primarily involving the potential for increased healthcare costs.
• Minimal physical risks since it involves evaluation and management rather than invasive procedures.

Benefits

• More comprehensive and personalized care for complex conditions.
• Improved treatment outcomes through detailed planning and thorough assessment.
• Enhanced coordination among healthcare providers.

Recovery

• No physical recovery needed.
• Follow-up as required based on the complexity of the patient's condition and care plan modifications.

Alternatives

• Standard evaluation and management services without additional time: Less costly but may not provide the same level of thoroughness.
• Telehealth consultations: Convenient but may limit detailed physical assessments.

Patient Experience

Patients might experience a higher level of personalized attention and a more comprehensive approach to their healthcare needs. Comfort measures and empathetic communication are key components during these extended sessions.