Online digital E&M, for a new patient, for up to 7 days, cumulative time during the 7 days; 21 or more 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 99426 designates prolonged office or other outpatient evaluation and management (E/M) service for each additional 30 minutes, 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 each additional 30 minutes.

Details

CPT code:

99426

Category:

Category I

Section:

Evaluation and Management (E/M)

Specialty:

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

Type:

Other Preventive Medicine Services

99426 plays a crucial role in E/M services, representing prolonged service in the office or other outpatient setting for each additional 30 minutes. Healthcare providers utilize this code when engaging in prolonged face-to-face time with patients, extending beyond the usual duration of E/M services for each additional 30 minutes. Its application 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; 21 or more 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; 21 or more minutes?

Per Encounter

Modifiers

-

Clinical use

Prolonged office or other outpatient evaluation and management service before and/or after the usual service period, on the same day, in the office or other outpatient setting.

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.

Upvio is helping you save valuable time with streamlined workflows and integrated tools.

Additional CPT Codes

Link copied