A leukemia patient who is on 10 medications suffered a heart attack. He is receiving physical therapy and occupational therapy as well as chemotherapy and radiation therapy. He meets the requirements for complex chronic care management services and his attending physician has spent one hour and 45 minutes in the direct care of this patient's management. What is the correct evaluation and management code for this complex patient?

Question

Quizplus · Accepted Answer

99487 is the correct code for the initial 60 minutes of clinical staff time directed by a physician within a calendar month. Code 99489 is correct for each additional 30 minutes of clinical staff time directed by a physician. This add-on code is multiplied by the number of additional 30-minute increments spent in this patient's care.
Code 99487 is incorrect by itself because the time involved with the patient was more than 60 minutes. Code 99489 is incorrect by itself because this is an "add-on" code and must be used in addition to another code. Codes 99487, 99489 x 2 is incorrect because the additional 30-minute increment would cause this code to be used for two hours or more of clinical staff time directed by a physician.

A Leukemia Patient Who Is on 10 Medications Suffered a Heart