Cardiology Coding Alert

Question: One of my colleagues said that CPT^® 2020 will delete current online E/M code 99444. Is this true, and if so, which codes will we report instead of 99444?

California Subscriber

Answer: Yes. CPT^® 2020 will delete current online E/M code 99444. In place of 99444, you will receive new code 99421 (Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes).

Like its predecessor, 99421 has some significant restrictions, which stipulate that the service has to be:

• Provided to an established patient (or guardian),
• Provided by a physician or other qualified health care professional (QHP), and
• Unrelated to an E/M service provided within the previous seven days.

This means that any online digital E/M service that results from a previous, or that results in a subsequent, E/M visit is not separately reported, and the online E/M service is incorporated into the related E/M visit.

Also, CPT^® has placed a seven-day cumulative time limitation on 99421 and made the code time-dependent. You will be able to use 99421 if your provider spends between five and 10 minutes on any asynchronous communications with the patient in that time; you will also be able to report longer time increments with new codes 99422 (… 11-20 minutes) or 99423 (… 21 or more minutes).

The deletion of 99444, and its replacement with 99421-99423, presents a teachable moment for coders and their providers.

“Coders will need to work with their providers to ensure that they are documenting the time factors of the new codes,” says Chelle Johnson, CPMA, CPC, CPCO, CPPM, CEMC, AAPC Fellow, billing/credentialing/auditing/coding coordinator at County of Stanislaus Health Services Agency in Modesto, California. “The time component was not required for 99444, so this will be an opportunity for education.”

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