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Summer 2015,Vol. 1
AMERICANMEDICALASSOCIATION
ESSENTIALCPT®CODINGRESOURCES
Relyon thebest-selling
CPT®Changes2016: An Insider's
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Invest in thisannual publication for themeaning
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•
Enhanced!
Rationales tocommunicate the reasons
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•
New!
Summaryof changes tableat thebeginning
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•
New!
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American Medical
Association
1
CPTCHANGES 2016
Evaluation andManagement
EValuationandManagement
EvaluationandManagement
Numerous changes have beenmade in theEvaluation andManagement Services (E/M) section, some
of which includes: (1) additionof “military history” to the social-history element in theE/M
guidelines; (2) revisionof inpatient neonatal andpediatric critical care guidelines to clarify appropriate
reporting of these services; (3) deletionof intensive care services codes 99481 and 99482 and addition
of new code 99184, which combines these services into a single code; (4) a section title has been
changed from “ComplexChronicCareCoordination” to “CareManagement Services”with an addition
of a new subsection “ChronicCareManagement Services” tobetter reflect themanagement services
describedby new code 99490; (5) additionof another new subsection, “ComplexChronicCare
Management Services,”with deletionof code 99488 and revisions of two codes 99487 and 99489.
Guidelines have been significantly revisedbecause of these twonew subsections. In addition, a new
subsection, guidelines, and codes 99497 and 99498 have been added for advance care planning.
SummaryofAdditions, Deletions, andRevisions
Code Description
99481
Total body systematic hypothermia in a critically ill neonateper day (List separately in addition to code forprimary
procedure).
99482
Selectivehead hypothermia in a critically ill neonate per day (List separately in addition to code for primary proce-
dure)
▲
99487
Complex chronic care coordinationmanagement services,with the following required elements:
multiple (two ormore) chronic conditionsexpected to last at least 12months, or until the deathof thepatient;
chronic conditions place the patient at significant risk of death,acute exacerbation/decompensation,or functional
decline;
establishment or substantial revision ofa comprehensive careplan;
moderate or high complexitymedical decisionmaking;
60minutesof clinical staff timedirectedbya physician or other qualified health care professional, per calendar
month.
first hour of clinical staff time directed by a physician orotherqualifiedhealth care professionalwithno face-to-face
visit,per calendarmonth
99488
firsthour of clinical staff time directed by a physician orother qualified health careprofessionalwithone face-to-
face visit,per calendarmonth
✚
▲
99489
eachadditional 30minutes of clinical staff time directed by a physician orother qualifiedhealth careprofessional,
per calendarmonth (List separately in addition to code for primary procedure)
#
•
99490
Code added
•
99479
Code added
▲
99497
Codeadded
✚
•
99498
Code added
▲
=Revised code
•
=New code
ut
=Containsnewor revised text
x
=Modifier51exempt
NEW!
Tabular summary
of changesat thebeginning
of each section.
NEW!
Sizeand4-colordesignmatch
CPT®Professional
for easeof use.
Samplepagescontain2015content.
Improved rationales
provideconcise
justifications for
thechanges
CPT®CHANGESWEBINAR—FREE!
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CPT®Changes2016: An
Insider’sView,
thewebinar featuresCPT®
Editorial Panel expertsdiscussing the latest
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andonyourown schedule.
