Care plan oversight services, established patient

Prolonged Evaluation and Management (E/M) services are essential in certain situations, requiring precise coding to capture the extended nature of patient encounters. CPT code 99425 designates prolonged office or other outpatient evaluation and management (E/M) service for the first hour, requiring direct patient contact beyond the usual service time. This code is applied when healthcare providers engage in prolonged face-to-face time with patients in the office or other outpatient setting, extending beyond the typical duration of E/M services for the first hour.

Details

CPT code:

99375

Category:

Category I

Section:

Evaluation and Management (E/M)

Specialty:

Care Plan Oversight Services

Type:

Care Plan Oversight

In the realm of E/M services, 99425 holds significance, representing prolonged service in the office or other outpatient setting for the first hour. Healthcare providers utilize this code when engaging in prolonged face-to-face time with patients, extending beyond the usual duration of E/M services during the initial hour. Its use ensures accurate documentation of efforts in providing extended care during patient encounters in the outpatient setting.

Under what category does Care plan oversight services, established patient fall?

Category I

What is the billing unit for Care plan oversight services, established patient?

Per Encounter

Modifiers

-

Clinical use

Care plan oversight services, at least 10 minutes of physician or other qualified health care professional time per calendar month.

Documentation

Care plan oversight services for a patient receiving home health agency care. Document the total duration of oversight services, including the start and end times, and describe the activities undertaken during the oversight, such as reviewing reports, communicating with the home health agency, and adjusting the care plan. (each additional 30 minutes)

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