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CPT® Code 99027 refers to the service of a physician being on call while not physically present in the hospital. This code is specifically utilized to account for the time a physician is available to provide care or respond to patient needs outside of the hospital setting. The term "on call" indicates that the physician is prepared to offer medical services if required, even though they are not in the hospital at that moment. It is important to note that this code is billed for each hour of on-call service, emphasizing the physician's availability rather than their physical presence. This code does not encompass any time spent on other reportable services or procedures, ensuring that the billing reflects only the on-call service provided during that hour. Understanding this distinction is crucial for accurate medical coding and billing practices.
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The use of CPT® Code 99027 is indicated in situations where a physician is required to be available for patient care while not physically present in the hospital. This may include various scenarios such as:
The procedure associated with CPT® Code 99027 involves the following steps:
After the on-call period has concluded, there are no specific post-procedure care requirements associated with CPT® Code 99027. However, it is essential for the physician to document their availability and any patient interactions that occurred during the on-call hours. This documentation is crucial for ensuring accurate billing and compliance with coding standards. Additionally, physicians should be prepared to follow up with any patients who required attention during their on-call period, ensuring continuity of care.
| Short Descr | OUT-OF-HOSP ON CALL SERVICE | Medium Descr | HOSPITAL MANDATED CALL SVC OUT-OF-HOSPITAL EA HR | Long Descr | Hospital mandated on call service; out-of-hospital, each hour | Status Code | Non-Covered Service | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Non-Covered Service, not paid under OPPS | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | M3 - Emergency room visit | MUE | 0 | CCS Clinical Classification | 227 - Other diagnostic procedures (interview, evaluation, consultation) |
| 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. | GQ | Via asynchronous telecommunications system |
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| 2013-01-01 | Changed | Guideline information changed. |
| 2003-01-01 | Added | Code Added |
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