CPT Code 98960

[CCO_Admin]

Desirae Cook asked:

A patient brings a physician order for long term Infusion Education and PICC line maintenence to a CAH ER - ER nurse provides the education over the course of an hour. Would this be an appropriate scenario to code 98960?

Answer:

using a standardized curriculum to an individual or a group of patients for the treatment of established illness(s)/disease(s) or to delay comorbidity(s). Education and training for patient self-management may be reported with these codes only when using a standardized curriculum as described below. This curriculum may be modified as necessary for the clinical needs; cultural norms and health literacy of the individual patient(s).

The purpose of the educational and training services is to teach the patient (may include caregiver) how to effectively self-manage the patients illness(s)/disease(s) or delay disease comorbidity(s) in conjunction with the patients professional healthcare team. Education and training related to subsequent reinforcement or due to changes in the patients condition or treatment plan are reported in the same manner as the original education and training. The type of education and training provided for the patients clinical condition will be identified by the appropriate diagnosis code(s) reported.