General Surgery Coding Alert

General Coding:

Use These Codes When Your Patient Phones From Home

Question: Which codes are appropriate to use for audio-only medical phone encounters?

AAPC Forum Participant

Answer: For audio-only phone visits, you’ll look to the Synchronous Audio-Only Evaluation and Management Services section of your CPT® book. 

For a new patient, you’ll reference the following codes:

  • 98008 (Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.)
  • 98009 (… low medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.)
  • 98010 (… moderate medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.)
  • 98011 (… high medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.)

For an established patient, you’ll look to these codes:

  • 98012 (Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 10 minutes must be exceeded.)
  • 98013 (… low medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.)
  • 98014 (… moderate medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.)
  • 98015 (… high medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.).

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC