Cardiology Coding Alert

Reader Questions:

Understand These E/M Guidelines

Question: When our providers perform online digital E/M services (99421-99423) services, what activities count toward cumulative service time?

AAPC Forum Participant

Answer: According to CPT®, the physician’s cumulative service time includes:

  • Reviewing the patient’s initial inquiry, which is when the seven-day period begins.
  • Reviewing patient records or data relevant to assessing their problem.
  • Personal physician or other qualified healthcare professional (QHP) interaction with the clinical staff that focuses on the patient’s problem.
  • Developing management plans, which include writing prescriptions and ordering tests.

Any subsequent communication with the patient through online, telephone, email, or other digitally supported communication does not otherwise represent a separately reported E/M service.

Important: “All professional decision making, assessment, and subsequent management by physicians or other QHPs in the same group practice contribute to the cumulative service time of the patient’s online digital E/M service,” per CPT®.