More Income for You, as New Codes Cover Video Patient Visits, Virtual Check-in, Remote Monitoring

Betsy Nicoletti, MS

Disclosures

February 18, 2019

In This Article

How to Use Code 99457

Code 99457 is defined by CPT as "remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month."

This code is for use when clinical staff or the practitioner use data from remote monitoring to manage a patient's condition. The device must be a medical device as defined by the FDA and the service ordered by a physician/NP/PA. This service may be reported in the same time period as transitional care management, chronic care management, and behavioral health integration codes.

As always, CPT tells us that you can't count the time toward both services. Also, consider:

  • This service requires live, interactive communication (20 minutes) with the patient or caregiver, provided by "clinical staff/physician/other qualified health care professional" in a calendar month;

  • Clinical staff time can be counted toward the 20 minutes;

  • This code requires interactive communication with the patient and/or caregiver;

  • The information obtained from the monitoring device is used in making treatment decisions for the patient's care;

  • It may be reported only once every 30 days, regardless of the number of parameters that are monitored;

  • It may not be reported with 99091; and

  • Do not count time related to an office visit, home visit, or domiciliary care visit, or any time related to code 93290, an implantable cardiac monitor.

The clinical example from CPT Changes 2019: An Insider's View for 99457 describes an 82-year-old woman with systolic dysfunction heart failure. On the basis of the interpreted data, the physician or other qualified healthcare professional uses the data to assess the patient's condition, communicate with the patient, and oversee the management of the condition.[4]

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