Forum - Questions & Answers

May 12th, 2022 - nia 4 

Ccm billing

99487 once/30 days
It sounds like we should wait to bill the total CCM time at the end of the month or for the previous month, since 99487 can only be used once, and 99489 is an add-on code. Are there any other primary codes that 99489 can be an add-on to?

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May 17th, 2022 - ChrisW   253  1 

re: CCM BILLING

Correct, add up your total time and bill at month-end. There are no other codes that should be reported with 99487.  According to AMA guidelines report 99489 in conjunction with 99487 and do not report 99489 for care management service of fewer than 30 minutes.  I hope this helps. Happy Coding! 

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May 23rd, 2022 - ChrisW   253  1 

re: CCM BILLING

You can bill anytime once the requirements have been met. Therefore, when reporting the first code 99487 of clinical staff time, under the direction of a physician or other qualified health care professional, at least 60 minutes up to 89 minutes (1hour-1 hour 29 minutes) are required, go ahead and submit your claim. Once the requirements have been made you can bill on that day or wait until the end of the month, but you do not need to hold everything until month-end, the only rule is that the add-on code is listed separately. It would make sense to bill the day it was completed for revenue purposes. Perhaps you can mark the chart somehow, identifying you are now working on the add-on codes, you can do this by either adding a chart in the EHR or a note or chart in the paper chart.  These codes can be reported for the lifetime of the patient, so It will be important to implement some sort of tracking method with dates, times, and when the codes are submitted.  
60-89 min 99487 X1 (less than 30 minutes in a calendar month- are not reported separately)
90-119 min 99487 X 1and 99489 X 1
120 Minutes or more 99487 X1, 99489 X 2, and 99489 for additional minutes. 
There are no other timed codes for reporting CCM except 99489, and 99487, however, you can report risk assessment codes either patient-focused using 96160 or caregiver-focused using 96161, these are additional add-on codes designated to be used with 99487 and 99489. In addition, 99487, 99489, 96160, and 96161 are acceptable primary codes as defined by the CPT manual, HCPCS, and/or CMS Policy.  Be sure and review all CPT guidelines on codes that cannot be billed with the above codes. 
 

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