Wiki Lab result Informing CPT code 99441,99442

[enya1998@gmail.com]

I work PCP office and we are starting NP inform directly pt the lab result by the phone or Video call(if possible, depends on the result) not released by MA anymore.
99441 and 99442 might accept some insurance but not all..
Another option, can we bill 99212 with mod instead??
Thanks!!!!

Telehealth CPT codes 99441 (5-10 minutes), 99442 (11-20 minutes)

 

[sls314]

Are they just calling to give the lab result, or is there additional workup being done on the call?

 

[thomas7331]

You cannot charge for just calling the patient with lab results. If you review the guidelines for codes 99441-2 you will see that these services must be initiated by the patient, not the provider, and cannot be related to an E/M service performed within the previous 7 days. 99212 is also incorrect as this is an E/M service which requires more than simply informing a patient of lab results.

 

[enya1998@gmail.com]

Are they just calling to give the lab result, or is there additional workup being done on the call?

yes, NP will inform the lab result upon their decision (not doing for NL) and discuss about the medication and more and also it will be done 7days.
Of course It will be held for only patient who wishes in this way (agreement signed).

 

[thomas7331]

yes, NP will inform the lab result upon their decision (not doing for NL) and discuss about the medication and more and also it will be done 7days.
Of course It will be held for only patient who wishes in this way (agreement signed).

Billing for management of the patient’s condition is appropriate based on documentation of the encounter. But just informing a patient by telephone of their lab results alone without additional services is not something that should be separately billed, whether the patient agrees to it or not.