General Surgery Coding Alert

Question: Is there a way to report chronic care management when the physician provides the service, not just the professional staff?

Texas Subscriber

Answer: Yes, you may use a new CPT^® 2019 code to bill physician chronic care management (CCM) services. The code is 99491 (Chronic care management services, provided personally by a physician or other qualified health care professional, at least 30 minutes of physician or other qualified health care professional time, per calendar month …).

Prior to the addition of this code, you had only the code for clinical staff time supervised by a physician, which is 99490 (Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month ...).

As your questions suggests, you could previously document and bill CCM services only when your surgeon supervised a care manager or a clinical staff member who was administering the patient’s care plan, but you now have a separate, physician code.

Coding caution: Aside from the credentials of the service provider, you’ll need to keep your eyes on the clock when you use either code. Code 99490 allows for “at least 20 minutes of clinical staff time … per calendar month,” while 99491 allows for an additional 10 minutes in that month.