Complex Chronic Care Management, Additional 20 min

Transitional care management is a critical aspect of patient care, demanding precise coding to capture the comprehensive nature of transitional services. CPT code 99480 designates transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge and medical decision-making of at least moderate complexity during the service period. This code is applied when healthcare providers engage in transitional care management services, including communication with the patient or caregiver within 2 business days of discharge and medical decision-making of at least moderate complexity.

CPT code:

99480

Category:

Category I

Section:

Explore Evaluation and Management CPT Codes

Specialty:

Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services

Type:

Initial and Continuing Intensive Care Services

Within the realm of transitional care management, 99480 plays a crucial role, representing services that include communication with patients or caregivers within 2 business days of discharge and medical decision-making of at least moderate complexity. Healthcare providers utilize this code to ensure accurate documentation of efforts in the comprehensive management of patients transitioning from one care setting to another.

Under what category does Complex Chronic Care Management, Additional 20 min fall?

Category I

What is the billing unit for Complex Chronic Care Management, Additional 20 min?

Per Encounter

Modifiers

Clinical use

Prolonged service in the inpatient setting, requiring direct patient contact beyond the usual service; each additional 30 minutes.

Documentation

Complex chronic care management services, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; establishment or substantial revision of a comprehensive care plan. Document the chronic conditions, risk factors, and the comprehensive care plan, including the start and end times of the service.