CPT 99427, in plain terms, covers A doctor's staff member provides follow-up care management services for an established patient beyond the initial visit. CPT 99427 is referenced in 2 tracked payer policy changes from Anthem BCBS and Molina Healthcare. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 99427 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 99427 on AAPC
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