Otolaryngology Coding Alert

Phone services aren't just MD territory in 2008 Nurses billing phone calls, e-visits and team conferences is no longer a "no-no." Get the facts on the new MD-E/M codes and their nonphysician counterparts so you can help your otolaryngologists evaluate your practice's 2008 E/M coding policies. Applaud Easier, Larger Call Code Selection Although payment hurdles may stop you from reporting telephone services, new codes -- if you use them -- will be easier to assign. CPT 2008 deletes complexity-based telephone call codes (99371-99373, Telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other healthcare professionals ...) and introduces two sets of time-based telephone services codes: - 99441-99443 -- Telephone evaluation and management service provided by a physician to an established patient, parent, or guardian not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment - - 98966-98968 -- Telephone assessment and management service provided by a qualified nonphysician healthcare professional to an established patient, parent, guardian not originating from a related assessment and management service provided within the previous seven days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment - Benefit: "I think that time-based reporting versus trying to determine what is -simple,- -intermediate- or -complex- is definitely a good thing," says Denae M. Merrill, CPC-E/M, coder for Covenant MSO in Saginaw, Mich. "You then have a clear-cut definition of what is what. A provider will then know what is important to document, and a coder will know what code is most appropriate, and there will be no room for arguing." Rules: Before reporting a telephone service, adhere to two global periods: 1. Seven-day pre-global: If an otolaryngologist treats a patient for a problem in the office and then discusses the problem with the patient on the phone in the next seven days, you would not bill the telephone service with 99441-99443. 2. 24 hours or soonest available appointment post-global: If an ENT provides a telephone E/M service and then sees the patient for the same problem within 24 hours or the next available visit, you forfeit the call code. You would report only the E/M service, such as 99212-99215 (Office or other outpatient visit for the evaluation and management of an established patient -). The idea is that the phone call should prevent in-office treatment. If you don't now report telephone services, the three new codes may make you reconsider your policy. CPT 2007 limited telephone care to physician-performed calls, which depending on state scope of practice also [...]