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The CPT® Code 99091 pertains to the collection and interpretation of physiologic data that is digitally stored and/or transmitted by the patient or caregiver to a physician or other qualified healthcare professional. This data may include various types of physiological measurements such as electrocardiograms (ECG), blood pressure readings, and glucose monitoring results. The healthcare professional responsible for interpreting this data must possess the appropriate qualifications, which include relevant education, training, and licensure as mandated by applicable regulations. The process requires a minimum of 30 minutes of dedicated time for the collection and interpretation of the data, and this time frame is critical for the proper reporting of the code. The physician or qualified healthcare professional reviews the transmitted data, provides a thorough analysis, and generates a written interpretation, ensuring that the patient's health status is accurately assessed based on the collected physiological information.
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The procedure associated with CPT® Code 99091 is indicated for the ongoing monitoring and assessment of patients who require regular evaluation of their physiological data. This may include patients with chronic conditions such as cardiovascular diseases, diabetes, or hypertension, where continuous monitoring of ECG, blood pressure, or glucose levels is essential for effective management. The transmission of this data allows healthcare professionals to make informed decisions regarding treatment adjustments and patient care based on real-time information.
The procedure for CPT® Code 99091 involves several key steps that ensure the accurate collection and interpretation of physiologic data. First, the patient or caregiver collects the relevant physiological data using approved monitoring devices, such as ECG monitors, blood pressure cuffs, or glucose meters. This data is then digitally stored and transmitted to the healthcare professional. Upon receipt of the data, the healthcare professional dedicates a minimum of 30 minutes to review and interpret the information. This includes analyzing trends, identifying any concerning changes, and correlating the data with the patient's medical history and current treatment plan. After thorough evaluation, the healthcare professional prepares a written interpretation of the findings, which may include recommendations for further action or adjustments to the patient's treatment regimen.
After the procedure associated with CPT® Code 99091, the healthcare professional may provide the patient with feedback based on the interpretation of the physiological data. This may include recommendations for lifestyle changes, adjustments to medication, or further diagnostic testing if necessary. The patient is encouraged to continue monitoring their physiological data regularly and to maintain communication with their healthcare provider regarding any new symptoms or concerns. Follow-up appointments may be scheduled to reassess the patient's condition and the effectiveness of any changes made to their treatment plan.
| Short Descr | COLLJ & INTERPJ DATA EA 30 D | Medium Descr | COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D | Long Descr | Collection and interpretation of physiologic data (eg, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | M5D - Specialist - other | MUE | 1 | CCS Clinical Classification | 227 - Other diagnostic procedures (interview, evaluation, consultation) |
| GW | Service not related to the hospice patient's terminal condition | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GT | Via interactive audio and video telecommunication systems | 24 | Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SA | Nurse practitioner rendering service in collaboration with a physician | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2021-01-01 | Note | Guidelines changed. |
| 2019-01-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Description Changed |
| 2002-01-01 | Added | First appearance in code book in 2002. |
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