Online digital E&M service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes

Prolonged Evaluation and Management (E/M) services are crucial in certain situations, requiring precise coding to capture the extended nature of patient encounters. CPT code 99423 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:

99423

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, 99423 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 service, for an established 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 service, for an established 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 beyond the second hour of the primary procedure, requiring total time with a qualified healthcare professional of at least 60 minutes beyond the typical service time.

Documentation

Prolonged office or other outpatient evaluation and management service before and/or after the usual service; first 30 minutes. Document the prolonged service, including the start and end times, and describe the specific activities or discussions that required the additional time.

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