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Wiki multiple telephone only appts

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misstigris

Networker
Messages
63
Location
Portland, OR
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What would you do in this scenario? I have a provider that has done phone only visits with a patient every 5 days. Since guidelines for phone only services state "They may not be provided if they are in follow-up for a visit within the past 7 days, or if they result in a visit in the next 24 hours, or next available appointment " would you code and submit the first visit (ex: DOS 5/1) , not bill for the second (ex: DOS 5/6 because its only 5 days from the first visit) then bill the third phone call (ex DOS 5/11) etc etc?
 
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That is what I originally thought, but then I started receiving denials from Medicare due to frequency? According to CPT, 99441-99443 are telephone evaluation & management services that cannot be originating from a related E/m service within the previous 7 days. Since 99441-99443 are E/M services it would make sense the reason for the denials. Do you have anything that states differently? Or are you getting paid from payors for multiple phone calls billed within a 7 day period?
 
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