How To Use CPT Code 99453

CPT 99453 is a code used for remote monitoring of physiologic parameters, including initial setup and patient education on equipment use. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 99453 procedures.

1. What is CPT 99453?

CPT 99453 is a medical billing code used for the initial setup and patient education on the use of remote physiologic monitoring equipment. This code is applicable when a healthcare provider instructs a patient on how to set up and use remote monitoring equipment to track and report parameters such as weight, blood pressure, blood oxygen levels, and expiratory flow rate.

2. 99453 CPT code description

The official description of CPT code 99453 is: “Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.”

3. Procedure

The 99453 procedure involves the following steps:

1. Assessment of the patient’s need for remote physiologic monitoring.
2. Selection of appropriate monitoring equipment based on the patient’s condition and needs.
3. Initial setup of the remote monitoring equipment at the patient’s location.
4. Training the patient on the proper use of the equipment, including how to record and transmit data.
5. Ensuring the patient understands the importance of regular monitoring and reporting of physiologic parameters.
6. Establishing a communication plan between the patient and healthcare provider for ongoing monitoring and support.

4. Qualifying circumstances

Patients eligible to receive CPT code 99453 services are those who:

• Have a medical condition that requires regular monitoring of physiologic parameters.
• Are capable of using the remote monitoring equipment and transmitting data as instructed.
• Have access to the necessary technology and resources to support remote monitoring (e.g., internet connection, compatible devices).
• Have a healthcare provider who is willing and able to provide ongoing support and monitoring of the patient’s condition using the remote monitoring data.

5. When to use CPT code 99453

It is appropriate to bill the 99453 CPT code when a healthcare provider sets up and trains a patient on the use of remote physiologic monitoring equipment for the first time. This code should not be used for subsequent monitoring sessions or for monitoring periods of less than 16 days. Additionally, CPT 99453 should not be reported more than once per episode of care.

6. Documentation requirements

To support a claim for CPT 99453, the following information should be documented:

• Patient’s medical condition and the need for remote physiologic monitoring.
• Type of monitoring equipment used and the specific physiologic parameters being monitored.
• Date of the initial setup and patient education session.
• Details of the patient’s training on equipment use, including any written or verbal instructions provided.
• Confirmation that the patient understands the importance of regular monitoring and reporting of physiologic parameters.
• Communication plan between the patient and healthcare provider for ongoing monitoring and support.

7. Billing guidelines

When billing for CPT code 99453, keep in mind the following guidelines and rules:

• Only report CPT 99453 once per episode of care.
• Do not report CPT 99453 for monitoring periods of less than 16 days.
• For supply of the remote physiologic monitoring equipment, including daily recordings and programmed alert transmission over a period of 30 days, use CPT code 99454.

8. Historical information

CPT 99453 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Similar codes to CPT 99453

Five similar codes to CPT 99453 and how they differentiate are:

• CPT 99454: This code is used for the supply of remote physiologic monitoring equipment and includes daily recordings and programmed alert transmission over a 30-day period.
• CPT 99457: This code covers remote physiologic monitoring treatment management services provided by a healthcare professional for at least 20 minutes per month.
• CPT 99458: This code is an add-on code for each additional 20 minutes of remote physiologic monitoring treatment management services provided by a healthcare professional per month.
• CPT 99091: This code is used for the collection and interpretation of physiologic data that is digitally stored and/or transmitted by the patient and/or caregiver to the healthcare provider.
• CPT 99490: This code covers chronic care management services provided by a healthcare professional for at least 20 minutes per month for patients with multiple chronic conditions.

10. Examples

Here are 10 detailed examples of CPT code 99453 procedures:

1. A patient with congestive heart failure requires regular monitoring of weight and blood pressure. The healthcare provider sets up a remote monitoring system and trains the patient on its use.
2. A patient with chronic obstructive pulmonary disease (COPD) needs to monitor their respiratory flow rate. The healthcare provider sets up a remote monitoring device and educates the patient on its proper use.
3. A patient with diabetes requires regular monitoring of blood glucose levels. The healthcare provider sets up a remote glucose monitoring system and trains the patient on its use.
4. A patient with hypertension needs to monitor their blood pressure regularly. The healthcare provider sets up a remote blood pressure monitoring device and educates the patient on its proper use.
5. A patient with sleep apnea requires monitoring of their pulse oximetry levels. The healthcare provider sets up a remote pulse oximeter and trains the patient on its use.
6. A patient with a history of heart arrhythmias needs to monitor their heart rate regularly. The healthcare provider sets up a remote heart rate monitoring device and educates the patient on its proper use.
7. A patient with chronic kidney disease requires regular monitoring of their weight and blood pressure. The healthcare provider sets up a remote monitoring system and trains the patient on its use.
8. A patient with asthma needs to monitor their peak expiratory flow rate. The healthcare provider sets up a remote monitoring device and educates the patient on its proper use.
9. A patient with a history of deep vein thrombosis requires regular monitoring of their blood clotting levels. The healthcare provider sets up a remote monitoring system and trains the patient on its use.
10. A patient with a history of stroke needs to monitor their blood pressure regularly. The healthcare provider sets up a remote blood pressure monitoring device and educates the patient on its proper use.