Advance Care Planning, First 30 min

CPT code 99497 designates advanced care planning, including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified healthcare professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate. This code is applied when healthcare providers engage in advanced care planning, including the explanation and discussion of advance directives, during a face-to-face encounter with the patient, family member(s), and/or surrogate, lasting for the first 30 minutes.

Details

CPT code:

99497

Category:

Category I

Section:

Evaluation and Management (E/M)

Specialty:

Advance Care Planning

Type:

Advance Care Planning

In the realm of advanced care planning, 99497 plays a crucial role, representing services that involve the explanation and discussion of advance directives during a face-to-face encounter. Healthcare providers utilize this code when spending the first 30 minutes engaging with the patient, family member(s), and/or surrogate in advanced care planning discussions. Its use ensures accurate documentation of efforts in facilitating important conversations about end-of-life care preferences.

Under what category does Advance Care Planning, First 30 min fall?

Category I

What is the billing unit for Advance Care Planning, First 30 min?

Per Encounter

Modifiers

Clinical use

Prolonged physician service in the inpatient or observation setting, requiring direct patient contact beyond the usual service.

Documentation

Prolonged physician service in the inpatient setting, requiring at least 15 minutes beyond the usual service. Clearly document each additional 15-minute increment of prolonged inpatient service, including the start and end times, and describe the specific activities or discussions justifying the additional time. (Critical care, each additional 30 minutes)