Transitional Care Management

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 99452 designates prolonged services in the inpatient setting, requiring direct patient contact beyond the usual service time. This code is applied when healthcare providers engage in prolonged face-to-face time with inpatients, extending beyond the typical duration of E/M services.

Details

CPT code:

99452

Category:

Category I

Section:

Evaluation and Management (E/M)

Specialty:

Non-Face-to-Face Services

Type:

Interprofessional Telephone/Internet/Electronic Health Record Consultations

99452 plays a crucial role in E/M services, representing prolonged services in the inpatient setting. Healthcare providers utilize this code when engaging in prolonged face-to-face time with inpatients, extending beyond the usual duration of E/M services. Its application ensures accurate documentation of efforts in providing extended care during patient encounters in the inpatient setting.

Under what category does Transitional Care Management fall?

Category I

What is the billing unit for Transitional Care Management?

Per Encounter

Modifiers

Clinical use

Prolonged preventive service(s) (beyond the typical service time of the primary procedure) in the inpatient setting.

Documentation

Prolonged service in the inpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes. Clearly document each additional 30-minute increment of prolonged inpatient service, including the start and end times, and describe the specific activities or discussions justifying the additional time.