Online digital E&M, for a new patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes

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.

CPT code:

99425

Category:

Category I

Section:

Explore Evaluation and Management CPT Codes

Specialty:

Preventive Medicine Services - Counseling Risk Factor Reduction and Behavior Change Intervention

Type:

Other Preventive Medicine Services

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 Online digital E&M, for a new patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes fall?

Category I

What is the billing unit for Online digital E&M, for a new patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes?

Per Encounter

Modifiers

Clinical use

Prolonged office or other outpatient evaluation and management service beyond the second hour of the primary procedure, requiring total time with a qualified healthcare professional of at least 90 minutes beyond the typical service time.

Documentation

Prolonged physician service in the inpatient setting, requiring at least 30 minutes beyond the usual service. Document the prolonged service, including the start and end times, and describe the specific activities or discussions that required the additional time.