Part B Insider (Multispecialty) Coding Alert

Published on Mon Oct 19, 2020 PDF

Time changes may improve coding difficulties.

If you’ve been looking forward to chronic care management (CCM) updates in the CPT^® 2021 revisions, you’re in luck. There are a few tweaks that simplify CCM coding starting Jan. 1.

You’ll also have to change the way you report 99490 (Chronic care management services …) next year. CPT^® has changed the time parameters from “at least 20 minutes of clinical staff time … per calendar month,” to the “first 20 minutes of clinical staff time … per calendar month.” You will then report time spent on the service over that 20-minute threshold with a new code, +99439 (… each additional 20 minutes of clinical staff time … per calendar month (List separately in addition to code for primary procedure)).

This change is reflected in another revision to 99487 (Complex chronic care management services …), which has been changed from “60 minutes of clinical staff time … per calendar month” to the “first 60 minutes of clinical staff time … per calendar month. Hopefully, this change “will decrease the challenge of reporting complex chronic care management slightly,” says Mary I. Falbo, MBA, CPC, CEO of Millennium Healthcare Consulting Inc. in Lansdale, Pennsylvania.

Additionally, CPT^® has deleted the current language in 99487 calling for the “establishment or substantial revision of a comprehensive care plan.” In the New Year, you’ll have to document that your physician’s comprehensive care plan has been “established, implemented, revised, or monitored,” suggesting that “no longer will you have to document a substantial care plan change in order to bill the code,” Falbo adds.