Primary Care Coding Alert

Caution: Don't discuss sensitive medical matters via unencrypted e-mails When your FP provides services to a patient via the Internet or other electronic means, he can save valuable time and effort. This arrangement also benefits patients because "E visits" can spare them a trip to the office. Did you know? Even though the visit isn't face-to-face, you can still collect deserved payment in many instances -- if you use the correct codes. Check this out: Researchers at the University of California-Berkeley and Stanford University evaluated the impact of Web visits on physician and patient satisfaction and healthcare costs. Participants included 282 physicians, 3,688 patients, and a matched control group. The study demonstrated "consistent costs savings [and] strong statistical significance," found lead researcher Laurence Baker, PhD, chief of health services research, Stanford University School of Medicine. Physician satisfaction ratings exceeded 90 percent among the highest-volume users. And more than three-quarters of the patients gave the service high marks, compared to telephone calls or office visits. For the five-month study period, physicians completed more office visits and produced more relative value units (RVUs) compared with the five-month control period from the previous year. Here's the expert scoop on how you can code and get paid for some of your physician's electronic communications with patients. Understand What Constitutes an E-Visit Electronic communications between physician and patient come in two types: online E/M services and telemedicine. Online E/M visits, consultations and Web-visits all fall under the term "e-visit," which is "a structured non-urgent consultation between a doctor and an established patient conducted over the Internet," says Linda Bishop, CPC, CSS, CHC, corporate compliance officer for a physician management group in Los Angeles. History: A code to recognize e-visit services became available when the AMA released 0074T-in 2005. If the AMA grants approval in November, you may see that this code is deleted from CPT 2008 because the service is no longer considered "emerging technology." You may instead use a new category-I code with a seven-day pre-global period. What you have to know: According to CPT guidelines, the physician must reply to the patient's online inquiry in a timely manner. Your practice must have permanent storage, either electronic or hard copy, of the encounter. Also, you can report this code only once during a seven-day period for any and all replies related to the patient's question. Watch out: If the physician has seen the patient for this problem within seven days of the online query, you should not bill the Internet communication. Instead, you would consider it part of the post-service work attached to the billed E/M service. You should also forgo reporting the new e-visit code if the patient's inquiry is regarding a recent [...]