Wiki Is there a CPT code for after hour calls

[warrenfamily103@gmail.com]

Hello,

I have two questions I'm trying to get an answer to asap. My provider is asking me two things...

1. The provider took an after hours on call phone call for a patient and spent a lot of time talking with her. Is there a code to bill this type of service? To reflect all the time taken?

2. If 15 minutes were spent with a caregiver in the office, can that service be coded? The patient was not seen, only the doctor discussing things with the caregiver.

Thank you in advance for any guidance.

 

[jkyles]

Hi there,
1. I'm assuming the call was not on the same day as a visit: During the public health emergency Medicare is covering the telephone E/M codes and I believe some private payers are still covering telephone visits too. If not, private payers may be covering virtual check in code G2012, which includes telephone calls. Just take note of the restrictions on these services, eg they can't be within 7 days of another E/M visit, etc.
2. There is not a stand-alone code office code for discussions with the caregiver.

 

[warrenfamily103@gmail.com]

Hi there,
1. I'm assuming the call was not on the same day as a visit: During the public health emergency Medicare is covering the telephone E/M codes and I believe some private payers are still covering telephone visits too. If not, private payers may be covering virtual check in code G2012, which includes telephone calls. Just take note of the restrictions on these services, eg they can't be within 7 days of another E/M visit, etc.
2. There is not a stand-alone code office code for discussions with the caregiver.

Thank you so much. The the call was not on the same day as a visit or within so many days after. This is a Medicare HMO risk plan so I don't know how that works with reimbursement since these plans don't pay like commercial plans. Maybe it's not worth even billing?

 

[jkyles]

If it is following Medicare rules you can bill the telephone call. It might be worth checking the plan's policy on telehealth and comms-based visits during the PHE.