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99358

A

amsmith

Guru
Messages
100
Location
Yucaipa, CA
Can we use 99358 when the telephone call was initiated by the physician not the patient?
 
I don't believe 99358 applies to telephone calls; there are other codes available for calls--look at 99441-99443. BUT the call must be initiated by the patient. Can you give more info about the circumstances?
 
Follow up on E&M

A great example is when the patient comes in for a visit and the patient will be starting a new medication, maybe 2 weeks later the physician will call the patient to see how they are doing with the changes rather than having the patient come in for another visit.
 
amsmith said:
A great example is when the patient comes in for a visit and the patient will be starting a new medication, maybe 2 weeks later the physician will call the patient to see how they are doing with the changes rather than having the patient come in for another visit.
Click to expand...

So in this situation, IMO, the only way the provider could expect reimbursement for that call, is if he directs the patient to call in after trying the med for a couple of weeks, to let him know of any concerns they may have--that way the "patient initiated the call" requirement is met. Just the time limit for the code you originally posted is unrealistic...99358 is for an hour. In order to bill it, he would have to spend at least 31 mins of extended time, which is highly unlikely. Looking at the time requirements for the codes I mentioned, the lowest is 5-10 mins, which is much more in line with what I would expect a call regarding medication problems to be. There are a few other requirements to bill these codes--have him read the paragraph for the Telephone Services guidelines. Also, not all payers will payers will pay these--namely Medicare and most of the replacement plans. We have had success with most of our commercial payers though, so it is possible, and can be a good way to bring in a little extra money for minimal effort.
 
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