What is medical billing code 99397?

Medical billing CPT code 99397 is used for reporting prolonged evaluation and management services that go beyond the usual care provided under a given level of service. It is typically assigned when the total time spent on a patient's care exceeds 30 minutes.

A brief description of CPT code 99397:

- Prolonged service(s) with direct (ie face to face) patient contact time beyond the usual service(s)

- Total time greater than 30 minutes

CPT code 99397 is an add-on code that can be appended to other Evaluation and Management (E/M) codes to indicate the additional time spent on a patient's case. It is important to note that this code should only be used when the care provided goes beyond the level of service that is typically associated with the original code.

For example, if a physician spends more than 30 minutes providing additional treatment and evaluation services to a patient during an office visit, they may choose to add CPT code 99397 to their claim to reflect the extended time dedicated to the patient's care.

Remember, medical billing codes are subject to specific rules and guidelines, so it's crucial for healthcare providers and billers to understand the criteria for using CPT code 99397 accurately to avoid claim denials or inaccuracies in medical billing