On the Cutting Edge? Check Out These ‘Remote’ CPT® 2019 Additions With MPFS Tips

The CPT® 2019 code set is adding to your options for remote services. Here’s a rundown of the changes you can expect for certain remote monitoring services as well as EHR consultative time.

Turn to 9945X for Remote Physiologic Monitoring

The new code set will add codes for remote physiologic monitoring (like weight, BP, pulse oximetry):

  • Use 99453 for set-up and educating the patient
  • Use 99454 to represent each 30 days of device supply with recordings or alerts
  • Use 99457 for 20 minutes or more per month spent by the provider or clinical staff on treatment management, including communication with the patient or caregiver.

Tip: The 2019 Medicare Physician Fee Schedule proposed rule indicates these codes are unlikely to be on the Medicare telehealth list because they don’t require face-to-face communication. But you may see the codes adopted for payment on the MPFS, so be sure to check coverage rules and values when the time comes.

Plan Ahead for Pulmonary Artery Pressure Sensor Changes

If you provide services for wireless pulmonary artery pressure sensors (or plan to), you’ll need to know 93264 for remote monitoring up to 30 days. The code requires weekly downloads (at minimum) of pressure recordings, as well as interpretation, trend analysis, and report by a physician/qualified healthcare professional.

Tip: The proposed 2019 MPFS reveals CMS plans to provide 0.70 work RVU for this code. Related sensor implant code 33289 is likely to have 6.00 work RVUs.

Will 99446-99449 See MPFS Status A in 2019?

With the next set of codes, we’ll branch out a bit from “remote” to interprofessional consult by phone, internet, or EHR.

Expect to see the bold text added to the descriptors for existing codes 99446-99449 for “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 health care professional.”

You’ll also see the addition of two related new codes. Code 99451 covers five minutes or more of consultative time with a written report (there’s no mention of a verbal report in this code’s descriptor, a difference from 99446-99449). Code 99452 will cover 30 minutes of phone, internet, or EHR referral services.

Tip: In 2018, the MPFS gives 99446-99449 status B, meaning payment is bundled into other services. The proposed 2019 MPFS shows these codes may change to status A, active, in recognition of how healthcare delivery is changing. Work RVUs will range from 0.35 to 1.40 for the existing codes. CMS proposed 0.5 work RVU for each of the new codes

What About You?

Are you excited to see the potential change in payment rules for the consultative physician?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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