“Our hope is that with better home monitoring, we can detect exacerbations, understand medication compliance and usage, and adjust therapy to prevent clinical worsening. This could be immensely useful in the care of COPD patients, many of whom are homebound and have difficulty travelling to office visits, especially during the COVID-19 pandemic.”
-Dr. Gelbman, Associate Clinical Professor of Medicine at Weill Cornell Medical College and New York Presbyterian Hospital
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Information on Coding
Wellinks provides this information for your convenience only. It is the responsibility of the provider to determine coverage and submit appropriate codes, modifiers, and charges for the services rendered.
- CPT Code 99453: Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), plus initial set-up and patient education on use of equipment. (Initial set-up and patient education of monitoring equipment included; do not report 99453 for monitoring of less than 16 days.)
- CPT Code 99454: Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days. (Initial collection, transmission, and report/summary services to the clinician managing the patient.)
- CPT Code 99457: Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified healthcare professional time in a calendar month, requiring interactive communication with the patient/caregiver during the month; first 20 minutes.
- CPT Code 99458: Each additional 20 minutes (List separately in addition to code for primary procedure.)
- CPT Code 99091: Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring), digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified healthcare professional, qualified by education, training, licensure/ regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days.
Disclaimer: Wellinks provides this information for your convenience only. It does not constitute legal advice or a recommendation regarding clinical practice. Information provided is gathered from third-party sources and is subject to change without notice due to frequently changing laws, rules and regulations. The provider has the responsibility to determine medical necessity and to submit appropriate codes and charges for care provided. Wellinks makes no guarantee that the use of this information will prevent differences of opinion or disputes with Medicare or other payers as to the correct form of billing or the amount that will be paid to providers of service. Please contact your Medicare contractor, other payers, reimbursement specialists and/or legal counsel for interpretation of coding, coverage and payment policies. Some payers may have policies that make it inappropriate to submit claims for such items or related service.
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