Respiratory Question for the Week of February 5, 2024

Question:

A patient undergoes remote physiologic monitoring (RPM) for weight, blood pressure, pulse oximetry, and respiratory flow rates using a medical device that meets the FDA’s definition. The collected and transmitted data are digitally transmitted, and the service is ordered by a physician. The patient receives education on using the device, and the device is supplied for daily recording or programmed alert transmissions. The monitoring duration is over 30 days. Which codes should be reported in 2024 for this remote physiologic monitoring service, and are there any specific conditions or limitations associated with reporting these codes?

Answer:

Codes 99453 and 99454 are used to report remote physiologic monitoring (RPM) services such as weight, blood pressure, pulse oximetry, or respiratory flow rates during a 30-day period in conjunction with the development and management of an individual’s treatment plan. To report 99453 and 99454, the medical device used must meet the FDA’s definition of one, and collected and transmitted data must be digitally transmitted rather than self-reported, and moreover, the service must be ordered by a physician or other qualified healthcare professional. Code 99453 may be used to report the setup and patient education on using the device. Code 99454 may be used to report the supply of the device for daily recording or programmed alert transmissions. Codes 99453 and 99454 are not reported if monitoring is fewer than 16 days. Do not report 99453 and 99454 when these services are included in other codes for the duration of time of the physiologic monitoring service (e.g., 95250 for continuous glucose monitoring requires a minimum of 72 hours of monitoring) or in conjunction with codes for more specific physiologic parameters.

This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.