Question:

When do we report codes 99453 and 99454?

Answer:

Codes 99453 and 99454 are used to report remote physiologic monitoring 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 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).

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.

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