CPT® Code 0189T | Case2Code

Code deleted, see 99499

Official Description

each additional 30 minutes (List separately in addition to code for primary service)

Common Language Description

The CPT® Code 0189T refers to the provision of off-site critical care evaluation and management services for critically ill or critically injured patients through remote real-time interactive video-conferencing. This service is designed to enhance on-site critical care when immediate critical care is unavailable or when the expertise of a specialized physician is required from a remote location. The off-site physician collaborates with the on-site medical team, which may include other physicians, nursing staff, and ancillary personnel, to review essential patient information and formulate a comprehensive plan of care. This collaboration ensures that the patient receives timely and appropriate critical care interventions. The off-site physician is responsible for monitoring the patient's condition, assessing any complications that may arise, and ordering necessary medical interventions. Through video technology, the remote physician can visually assess the patient, order diagnostic tests, and interpret the results, thereby facilitating real-time decision-making. The off-site physician also has the authority to initiate changes to the treatment plan and direct interventions as required. It is important to note that CPT® Code 0189T is specifically used to bill for each additional 30 minutes of remote critical care services provided on the same calendar day, following the initial 30-74 minutes of service, which is billed using CPT® Code 0188T.

1. Indications

The following indications outline the circumstances under which CPT® Code 0189T is utilized for off-site critical care services:

Critically Ill Patients Patients who are experiencing life-threatening conditions requiring immediate and continuous medical attention.
Critically Injured Patients Individuals who have sustained severe injuries that necessitate urgent critical care intervention.
Unavailability of On-Site Critical Care Situations where on-site critical care services are not available, necessitating remote evaluation and management.
Need for Specialized Expertise Cases where the on-site medical team requires the expertise of a specialized physician located at a remote site to manage the patient's condition effectively.

2. Procedure

The procedure for utilizing CPT® Code 0189T involves several key steps that ensure comprehensive remote critical care management:

Initial Collaboration The off-site physician begins by collaborating with the on-site medical team, which may include other physicians and nursing staff. This collaboration is crucial for gathering pertinent patient information and understanding the current clinical situation.
Plan of Care Development After reviewing the necessary information, the off-site physician works with the on-site team to develop a detailed plan of care tailored to the patient's specific needs. This plan outlines the necessary interventions and monitoring required for the patient's condition.
Remote Monitoring The off-site physician then engages in continuous monitoring of the patient through real-time video-conferencing. This allows the physician to visually assess the patient's condition and make informed decisions regarding their care.
Intervention and Orders As the patient's condition evolves, the off-site physician has the authority to order tests, review and interpret results, and initiate changes to the treatment plan as necessary. This proactive approach ensures that the patient receives timely interventions.
Ongoing Communication Throughout the process, the off-site physician maintains communication with the on-site team, nursing staff, and other ancillary personnel to ensure coordinated care and address any emerging complications or needs.

3. Post-Procedure

Post-procedure care following the use of CPT® Code 0189T involves continued monitoring of the patient's condition by both the off-site physician and the on-site medical team. The off-site physician may follow up on the interventions ordered and assess the effectiveness of the treatment plan. Additionally, ongoing communication between the off-site and on-site teams is essential to adapt the care plan as the patient's condition changes. The expectation is that the patient will receive comprehensive care that addresses their critical needs, with the off-site physician playing a vital role in the management and oversight of their treatment.

Short Descr	VIDEOCONF CRIT CARE ADDL 30
Medium Descr	VIDEOCONFERENCED CRITICAL CARE EA ADDL 30 MIN
Long Descr	each additional 30 minutes (List separately in addition to code for primary service)
Status Code	Non-Covered Service
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Items and Services Not Billable to the MAC
Type of Service (TOS)	9 - Other Medical Items or Services
Berenson-Eggers TOS (BETOS)	M5D - Specialist - other
MUE	Not applicable/unspecified.
CCS Clinical Classification	227 - Other diagnostic procedures (interview, evaluation, consultation)