Question Remote Patient Monitoring

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Does anyone have experience billing CPT 99091 versus 99490 along with CPT codes 99453, 99454 and 99457? CPT 99091 requires 30 minutes physician/QHCP time whereas 99490 requires 20 minutes but could be by clinical staff. CPT 99457 also requires 20 minutes and can be by clinical staff. The scenario in discussion is that the physician/QHCP is spending time during month span separate from the time spent by the clinical staff and want to capture both if CPT codes permit.
 

kathrynw

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Hi,
According to NCCI edits 99091 is a column 2 code for 99453, 99454, and 99457 and cannot be billed together under any circumstances, these are bundled.
Hopefully this helps,
 
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Hi -
Thank you for your reply. So in reviewing the NCCI edits, I see the rationale given of Column I (0206T) can not be billed with Column II (99091), but nothing about 99091 used with the other 3 codes (99453,99454,99457). This year, CPT 99091 was unbundled so it could be billed separately. I believe 99453, 99454 and 99457 can all billed at the same time and they are in column II so do not understand why 99091 would be treated differently when it is in column II as well? Thanks again.
 
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mccoyheather

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Can separate md's report professional vs technical RPM? example: Dr. A writes script to RPM Dr. B company ordering RPM, Dr. A provides 99453 and 99457 RPM treatment and management. Dr B bills for 99454 - Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days .
Please help!!!
 
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Help needed please. We are just starting to bill for remote patient monitoring codes 99453,99454 and 99457. I am setting up the codes in our software system, but I want to make sure that I am entering the correct place of service codes for these procedures. Would I bill them with 2 for telehealth? Also what type of service code would be used?
 
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