Internal Medicine Coding Alert

Reader Question:

Physician Provides Telephone Orders

Question: Our office has been treating an anemic patient weekly with Procrit. She has moved to a nursing home and is unable to come to the office now for treatment but still needs to receive her Procrit. Our doctor has called in orders for Procrit to the nursing home. Can I charge for these phone orders and, if so, how should I code so Medicare will pay?

California Subscriber

Answer: Medicare will not reimburse for telephone conversations, as specified in Section 15512 (B) of the Medicare Carriers Manual, "Do not pay for telephone calls (codes 99371-99373) because payment for telephone calls is included in payment for billable services (e.g., visit, surgery, diagnostic procedure results)." You can bill only for face-to-face services on an outpatient, noncritical care basis.

You should note that some insurance companies may provide reimbursement for telephone conversations. If you provide telephone services to a patient with private insurance, you should check with the payer to determine its policies and procedures regarding the telephone-call codes (99371-99373).

 

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