CPT code 98004 refers to a telemedicine visit where a doctor evaluates and manages the health of an existing patient using an online video call. CPT 98004 represents “Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.”.
Procedure Explanation:
This procedure involves a doctor meeting with you through a video call to assess your health, which includes asking about your medical history or doing a basic examination. The visit should last at least 10 minutes for billing, and it’s a routine check-up for patients the doctor has seen before. It’s important to note that this visit is limited to straightforward issues, meaning it’s for fairly simple medical concerns.
Common Names:
- Virtual Health Check
- Telehealth Visit
- Online Medical Evaluation
Relative Value Units (RVU):
The RVUs associated with this code are 0.7.
How This Procedure Appears:
- Operating Room Schedule Name: N/A, as this is a non-surgical procedure
- Surgical Consent Form Name: N/A, as this is a non-surgical procedure
Typical Patients and Diagnoses:
This procedure is often used for patients who need routine follow-ups or management of ongoing conditions from the comfort of their home. For example, someone managing a mild chronic condition like controlled diabetes might use this service for regular check-ins without needing to visit the clinic in person.
Associated ICD-10 Codes:
- Z71.1: This code refers to an encounter for a routine health exam without any complaints or symptoms.
- E11.9: This is used when talking about someone with type 2 diabetes who doesn’t have any complications.
- Z76.0: This represents a health visit for someone seeking a second opinion on a previous diagnosis or treatment.
Summary
In summary, code 98004 describes a video-based medical consultation for existing patients. Typical ICD-10 codes associated with 98004 include Z71.1 (routine health exam) and E11.9 (type 2 diabetes without complications).
Disclaimer
This post is for informational purposes only and is not a substitute for medical advice. “CPT” and CPT Codes are registered trademarks of the American Medical Association. HCPCS codes are managed by Medicare and are not subject to copyright.