Summary & Overview
CPT 4551F: Performance/Status Measure Entry
CPT code 4551F is listed without an accompanying summary; it appears to function as a performance or status measure within the CPT code set. As a CPT-designated code, it is part of the national procedural coding framework used by clinicians and payers for documentation and quality reporting. Its presence in administrative records can affect clinical documentation workflows, claims adjudication, and quality measurement activities.
Key payers in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's role in clinical documentation and billing, discussion of which major payers commonly accept CPT-coded entries for reporting purposes, and guidance on the types of benchmarks and policy updates to monitor. The publication will also outline the clinical context typically associated with performance/status measures and note where supplemental data is required for full implementation.
Data not provided in the input includes explicit service type, typical site of service, associated modifiers, taxonomies, ICD-10 diagnoses, related codes, and service line. Those items are identified as missing and will be highlighted where applicable in supporting sections of the full publication.
Billing Code Overview
CPT code 4551F has no summary available in the source description. Based on the code listing, this entry represents a performance or status measure rather than a discrete clinical procedure. Service type: Data not available in the input. Typical site of service: Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old male presenting to a colorectal surgery clinic with chronic left lower quadrant abdominal pain, altered bowel habits, and intermittent rectal bleeding. After colonoscopic evaluation identifies a limited segment of symptomatic diverticular disease with recurrent episodes and localized inflammation, the surgeon schedules an elective segmental sigmoid resection. The clinical workflow includes preoperative evaluation, informed consent, perioperative risk assessment, surgical scheduling, performance of the sigmoid colectomy under general anesthesia in an operating room or ambulatory surgery center as appropriate, postoperative inpatient recovery with pain control and early ambulation, and follow-up visits for wound check and assessment of bowel function. Perioperative documentation includes operative report, anesthesia record, pathology submission, and discharge summary, with coding and billing completed from the operative and visit documentation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure | Use when a separate E/M visit is documented on the same day as the surgical procedure with distinct history, exam, and medical decision making. |
57 |