“ADD ON CODE FOR NON-COMPLEX CCM SERVICE, EACH ADDITIONAL 20 MINUTES OF CLINICAL STAFF TIME DIRECTED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (LIST SEPARATELY
IN ADDITION TO CODE FOR PRIMARY PROCEDURE)”
CATEGORY
Chronic Care Management Services
CODE TYPE
Timed based code
Billed in 20 minutes increment
ADD-ON CODE
99490
CPT 99439 is billed to patients receiving chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, once a month.
CODING CRITERIA
For CPT 99439, the following criteria should be met:
Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
For this CCM service each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional are required
Chronic conditions that lead to the risk of death, acute exacerbation/decompensation, or functional decline of patient
Comprehensive care plan established, revised, implemented, or monitored
Billed twice per calendar month (List separately in addition to code for primary procedure)
BILLING CRITERIA
99439 should not be reported more than twice per calendar month, as it can be billed only twice a month. CODE FIRST
CPT 99439 requires code first i.e. 99490
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