© Copyright 2025 American Medical Association. All rights reserved.
| Short Descr | PROLNG SVC I/P/OBS 1ST HOUR | Medium Descr | PROLONGED SVC I/P OR OBS SETTING 1ST HOUR | Long Descr | Prolonged service in the inpatient or observation setting, requiring unit/floor time beyond the usual service; first hour (List separately in addition to code for inpatient or observation Evaluation and Management service) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | M2B - Hospital visit - subsequent | MUE | Not applicable/unspecified. | CCS Clinical Classification | 227 - Other diagnostic procedures (interview, evaluation, consultation) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2022-12-31 | Deleted | Code deleted. For prolonged evaluation and management services on the date of an inpatient or observation or nursing facility service, use 99418. |
| 2021-01-01 | Changed | Code changed. |
| 2018-01-01 | Changed | Guideline information changed. Added 90847 per AMA 2018 corrections document. |
| 2013-01-01 | Changed | Guideline information changed. Also, added code 90837 per AMA 2013 corrections document. |
| 2012-01-01 | Changed | Code ranges changed per AMA 2012 corrections document |
| 2011-07-01 | Changed | AMA guidelines code range reverted back to its original state per AMA corrections document. |
| 2011-01-01 | Changed | Short description changed. |
| 2009-01-01 | Changed | Code description changed |
| 1994-01-01 | Added | First appearance in code book in 1994. |
Get instant expert-level medical coding assistance.