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Pediatric Coding Alert

Reader Questions:

Start With 99358 for Records Review

Published on Tue Jul 13, 2010

Question: I've heard that CPT has a new code for reviewing records separate from an appointment. Is this true? If so, what do we need to know before reporting it? Massachusetts SubscriberAnswer: CPT 2010 doesn't include new codes for records review, but already has three codes in place for those situations. The most helpful option for pediatricians is 99358 (Prolonged evaluation and management service before and/or after direct [face-toface] patient care; first hour). Code 99358 applies to non faceto- face services of 30 to 75 minutes.Similar choices include 99455 (Work related or medical disability examination by the treating physician ...) and 99456 (Work related or medical disability examination by other than the treating physician ...)The descriptors for 99455 and 99456 include examples of the services covered, such as completion of a medical history commensurate with the patient's condition; development of future medical treatment plan; completion of necessary documentation/certificates and report; [...]
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