Hello,
I am needing clarification on billing E&M services with a follow-up via digital phone calls. I have a couple of different scenarios that I am unsure of.
Scenario 1: A patient is seen in the office for cough and congestion among other symptoms and the provider diagnosis's he patient with the flu and prescribes medication. This visit is billed with the appropriate E&M code. Then the patients contact the office via phone call (within a 7 day period) to talk to the provider because their symptoms have not improved. The provider the discusses with the patient the worsening symptoms (no new symptoms were reported) and codes it with a different diagnosis code and prescribes a different medication. Can the provider bill for the "follow-up" call using the digital telephone codes of 99441 -99443 in this scenario?
Scenario 2: A patient is seen in the office for cough and congestion among other symptoms and the provider diagnosis's he patient with the flu and prescribes medication. This visit is billed with the appropriate E&M code. Then the patients contact the office via phone call (within a 7 day period) to talk to the provider because their symptoms have not improved. The provider the discusses with the patient the worsening symptoms (no new symptoms were reported) and codes it using the same diagnosis code as the in-office visit but prescribes a different medication. Can the provider bill for the "follow-up" call using the digital telephone codes of 99441 -99443 in the scenario?
I know if the CPT book it states that if a telephone call refers to an E&M service that is within the 7 day period then the "follow-up" is considered to be included in the original E&M service billed and they can not bill 99441-99443 for the digital phone call. ( that is how I am interpreting it). However, I am getting conflicting information stating that if the diagnosis or medication is changed, then the 99441-99443 codes CAN be billed. Is this correct? If so, can someone point me in the direction to find this information?
Can someone also point me in the direction to find the most recent updates for Telehealth or digital calls? I've heard there has been an update recently and I am needing the content of that update but I can seem to find anything other than the 2021 coding update guidelines.
Thank you in advance.
I am needing clarification on billing E&M services with a follow-up via digital phone calls. I have a couple of different scenarios that I am unsure of.
Scenario 1: A patient is seen in the office for cough and congestion among other symptoms and the provider diagnosis's he patient with the flu and prescribes medication. This visit is billed with the appropriate E&M code. Then the patients contact the office via phone call (within a 7 day period) to talk to the provider because their symptoms have not improved. The provider the discusses with the patient the worsening symptoms (no new symptoms were reported) and codes it with a different diagnosis code and prescribes a different medication. Can the provider bill for the "follow-up" call using the digital telephone codes of 99441 -99443 in this scenario?
Scenario 2: A patient is seen in the office for cough and congestion among other symptoms and the provider diagnosis's he patient with the flu and prescribes medication. This visit is billed with the appropriate E&M code. Then the patients contact the office via phone call (within a 7 day period) to talk to the provider because their symptoms have not improved. The provider the discusses with the patient the worsening symptoms (no new symptoms were reported) and codes it using the same diagnosis code as the in-office visit but prescribes a different medication. Can the provider bill for the "follow-up" call using the digital telephone codes of 99441 -99443 in the scenario?
I know if the CPT book it states that if a telephone call refers to an E&M service that is within the 7 day period then the "follow-up" is considered to be included in the original E&M service billed and they can not bill 99441-99443 for the digital phone call. ( that is how I am interpreting it). However, I am getting conflicting information stating that if the diagnosis or medication is changed, then the 99441-99443 codes CAN be billed. Is this correct? If so, can someone point me in the direction to find this information?
Can someone also point me in the direction to find the most recent updates for Telehealth or digital calls? I've heard there has been an update recently and I am needing the content of that update but I can seem to find anything other than the 2021 coding update guidelines.
Thank you in advance.