Hi! I have questions surrounding using CPT 99457 using the example.
Example: Company A installs RPM devices in SNFs for patient monitoring. Company A is performing a service for the SNFs, and is not otherwise affiliated with them. Each RPM device monitors one specific patient, and a device is installed for each consenting patient. The patient/POA signs a consent allowing the use of the RPM. Company A supplies the SNFs with 24/7 RPM data, including an electronic database and daily updated reports on patient physiologic changes. On a daily basis clinical staff at Company A review the data and EHR of patients with abnormal physiologic changes and send "alerts" to the SNFs for specific patients appearing at risk for decompensation. Company A communicates specifically with the SNFs regarding the patients, and does not communicate with the patients/POAs themselves. Company A has physicians on staff that periodically review the patient's data and are available to QHCP's working under them who are reviewing the data daily.
Because the RPM devices are monitoring SNF patients, can the interactive monthly communication be done with SNF healthcare staff instead of the patient?
Who needs to write the order for the RPM, the SNF physician or Company A's physician, or either?
What aspects of this workflow could be billed as part of the 20 minutes?
Is there anything about the example that makes you question if 99457 is actually applicable?
Example: Company A installs RPM devices in SNFs for patient monitoring. Company A is performing a service for the SNFs, and is not otherwise affiliated with them. Each RPM device monitors one specific patient, and a device is installed for each consenting patient. The patient/POA signs a consent allowing the use of the RPM. Company A supplies the SNFs with 24/7 RPM data, including an electronic database and daily updated reports on patient physiologic changes. On a daily basis clinical staff at Company A review the data and EHR of patients with abnormal physiologic changes and send "alerts" to the SNFs for specific patients appearing at risk for decompensation. Company A communicates specifically with the SNFs regarding the patients, and does not communicate with the patients/POAs themselves. Company A has physicians on staff that periodically review the patient's data and are available to QHCP's working under them who are reviewing the data daily.
Because the RPM devices are monitoring SNF patients, can the interactive monthly communication be done with SNF healthcare staff instead of the patient?
Who needs to write the order for the RPM, the SNF physician or Company A's physician, or either?
What aspects of this workflow could be billed as part of the 20 minutes?
Is there anything about the example that makes you question if 99457 is actually applicable?