Ob-Gyn Coding Alert

Question: Our patients have learned that if they call the on-call physician over the weekend, they can typically get what they need without having to make an appointment. The physicians are at a disadvantage because they dont have access to the patients records and feel to deny birth-control prescription requests or other similar, immediate needs would be poor service. One physician spent nearly three hours on the phone with patients who called the answering service. Is there a code I can submit to recover some of our physician costs?

Kentucky Subscriber

 
Answer: Although the 99371-99373 series (telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other health care professionals [e.g., nurses, therapists, social workers, nutritionists, physicians, pharmacists]) covers this type of service, no payer reimburses for these codes.
 
You can either charge the patient for the time or get the physicians into a better triage system to keep them off the phone. If you are going to charge the patients, be sure to let your patient population know about this change in advance. Otherwise, your physicians are spending time and providing a service, and doing so for free.
 
If you are successful in getting the patient to come in, there is one way to get credit for the telephone call with the patient, however. If a quick phone call is made regarding a problem and the patient shows up within a short time to be seen for that problem, the note documenting the phone call can be part of the medical decision making for the visit toward the E/M level (e.g., reviewing test results or prescribing or renewing medication). You can also refer to that note in the chart if the physician does not want to repeat writing down the symptoms, etc., so they can be counted as part of the history of present illness.