CPT® Code: 99421
Description:
CPT® 99421 is used for online digital evaluation and management (E/M) services provided to an established patient. This code covers 5–10 minutes of cumulative time spent by a healthcare provider in reviewing patient-submitted information, including medical history, symptoms, and follow-up questions, via secure online platforms or patient portals.
When to Use:
- Established patients submit non-urgent medical questions or updates through a secure online portal.
- Providers review the patient’s information, assess their condition, and provide recommendations or care instructions digitally.
- Useful for managing chronic conditions, medication adjustments, or routine follow-ups without requiring an in-person visit.
Requirements for Billing:
- Patient must be established in the practice.
- Services must occur through a secure, HIPAA-compliant digital platform.
- Documentation must include the time spent, nature of the communication, and clinical recommendations provided.
- Only cumulative time over a 7-day period is considered; multiple messages may be combined to meet the 5–10 minute threshold.
Includes:
- Reviewing patient-submitted information (symptoms, questions, labs).
- Providing digital counseling, guidance, or treatment adjustments.
- Documentation of recommendations and follow-up instructions in the patient record.
OptiMantra Integration:
OptiMantra’s EMR includes a secure patient portal that simplifies digital E/M services. Providers can document patient communications and time spent, and integrate recommendations directly into the patient’s chart. This not only ensures accurate billing for CPT® 99421 but also streamlines workflows, improves patient engagement, and enhances continuity of care.
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