Ob-Gyn Coding Alert

Question: When our providers perform online digital evaluation and management (E/M) services (99421-99423), what activities count toward cumulative service time?

AAPC Forum Participant

Answer: According to CPT^®, the physician’s cumulative service time includes:

• Reviewing the patient’s initial inquiry, which is when the seven-day period begins
• Reviewing patient records or data relevant to assessing their problem
• Personal physician or other qualified healthcare professional (QHP) interaction with the clinical staff that focuses on the patient’s problem
• Developing management plans, which include writing prescriptions and ordering tests

Any subsequent communication with the patient through online, telephone, email, or other digitally supported communication does not otherwise represent a separately reported E/M service.

Important: “All professional decision making, assessment, and subsequent management by physicians or other QHPs in the same group practice contribute to the cumulative service time of the patient’s online digital E/M service,” per CPT®.