Non-face-to-face Prolonged Evaluation and Management, 30+ min

Prolonged Evaluation and Management (E/M) services are essential in certain situations, demanding precise coding to capture the extended nature of patient encounters. CPT code 99469 designates prolonged clinical staff service (clinical staff is required) in the office or other outpatient setting, requiring direct supervision by a physician or other qualified healthcare professional. This code is applied when clinical staff provides prolonged services in the office or other outpatient setting under the direct supervision of a physician or other qualified healthcare professional, extending beyond the typical duration of E/M services.

Details

CPT code:

99469

Category:

Category I

Section:

Evaluation and Management (E/M)

Specialty:

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

Type:

Inpatient Neonatal and Pediatric Critical Care

In the landscape of E/M services, 99469 plays a crucial role, representing prolonged clinical staff service in the office or other outpatient setting. Clinical staff, under the direct supervision of a physician or other qualified healthcare professional, utilizes this code when providing prolonged services, extending beyond the usual duration of E/M services. Its use ensures accurate documentation of efforts in providing extended care during patient encounters in the outpatient setting.

Under what category does Non-face-to-face Prolonged Evaluation and Management, 30+ min fall?

Category I

What is the billing unit for Non-face-to-face Prolonged Evaluation and Management, 30+ min?

Per Encounter

Modifiers

-

Clinical use

Evaluation and management of the patient, including obtaining an extended history, examining the patient, and making straightforward medical decision making (typically 25 minutes).

Documentation

Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician, including a verbal and written report to the patient's treating/requesting physician or other qualified healthcare professional. Document the assessment and management service, the communication with the treating/requesting physician, and the verbal and written report. (each additional 30 minutes)

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Additional CPT Codes

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