Below goes on to say that these codes are for when the patient initiates the phone consultation. I don't believe that your scenario meets the criteria to bill a telephone E/M and to bill a regular EM whether it be inpatient subsequent care the physician would have to have a face to face interaction with the patient.
Below is the additional information on Telephone E/M
This code is to be used when the patient initiates the call. "Telephone Services - Telephone services are non-face-to-face evaluation and management (E/M) services provided by a physician to a patient using the telephone. These codes are used to report episodes of care by the physician initiated by an established patient or guardian of an established patient. If the telephone service ends with a decision to see the patient within 24 hours or next available urgent visit appointment, the code is not reported; rather the encounter is considered part of the preservice work of the subsequent I/M service, procedure, and visit. Likewise if the telephone call refers to an E/M service performed and reported by the physician within the previous seven days (either physician requested or unsolicited patient follow-up) or within the postoperative period of the previously completed procedure, then the service(s) are considered part of that previous E/M service or procedure. (Do not report 99441-99443 if reporting 99441-99444 performed in the previous seven days.)"
CPT Assistant March 2008, Volume 18, Issue 3, pages 6 - 7
Medical care has traditionally been considered a face-to-face service provided in the office, hospital or nursing facility, patient?s home, or clinic setting. Due to advancements in communication technology and social change including patient empowerment, the need to provide greater access to care and chronic disease management have challenged the traditional face-to-face care paradigm, expanding the ways in which patients engage with their physicians and other healthcare providers. The Institute of Medicine report, Crossing the Quality Chasm (2001), envisions a patient-centered, responsive care-delivery system that leverages technology to transform care from a visit-based approach to one that is a continuous healing relationship in which the patient exercises greater control in the processes of care. To this end, CPT 2008 has established a new section, Non-Face-to-Face Physician Services, that includes a Telephone Services subsection.
Codes 99441-99443 were established to describe telephone services initiated by the patient, parents or guardian and provided by a physician to an established patient via telephone. They represent non-face-to-face evaluation and management services provided by the physician to an established patient that do not lead to a related office visit. Communications with the office staff, whether they do or do not end in an office visit, are not reported by these codes. When the physician initiates regular telephone communications to patients, family, or guardians as a component of care management for one or more chronic illnesses, the Care Plan Oversight Services codes (99374-99380) should be reported.
Conditions and Guidelines
? The telephone service is initiated by an established patient, parent, or guardian of an established patient. If a physician is covering after hours for a colleague with whom the patient has an established doctor-patient relationship, the covering physician may be considered to have an established relationship with the colleague?s patient or guardian.
? If the telephone service ends with a decision to see the patient within 24 hours or the next available urgent visit appointment, a telephone service code is not reported. In this instance, the telephone encounter is considered part of the preservice work of the subsequent E/M service, procedure, and visit.
? If the telephone call is in reference to an E/M service performed and reported by the physician within the previous seven days (either physician requested or unsolicited patient follow-up) or within the postoperative defined global period of a previously completed procedure, then the telephone service is considered part of that previous E/M postservice work and should not be reported separately.
? The telephone E/M service codes are now distinguished by the length of the medical discussion with the patient, parent, or guardian rather than the complexity of the conversation utilized in the deleted 99371-99373 codes.
99441 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 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
99442 11-20 minutes of medical discussion
99443 21-30 minutes of medical discussion
Clinical Example (99441)
An established patient calls her physician with a new complaint. The physician obtains a brief history, inquires about the patient?s present medication use, and makes treatment recommendations, all of which are recorded in the patient?s medical record. The patient is instructed about the condition and advised to call if the symptoms fail to improve with the recommended treatment. No office visit is required.
Description of Procedure
The physician obtains a brief history via telephone, assesses the patient?s condition, makes a medical decision, and communicates that decision via telephone to the patient. Total medical discussion is 5-10 minutes.
Telephone services expand health care access for patients who may not need to or are unable to come to a physician?s office. These services can also make available advice and care to those who might otherwise seek more expensive care in an urgent care center or overcrowded emergency department, and offer a solution in helping to decrease health care costs by providing an alternative to more costly face-to-face services.