Question Non-Face-to-Face Evaluation Review - Phone Call with New Patient

jkmonaco

New
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4
Location
Missoula, Montana
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Is there a cpt code that can be billed for a patient we did not physically see but we got a referral for. Dr. spent 2 hours reviewing records. He even consulted another provider about this patient. He spoke with the patient over the phone, to basically tell him we won’t see him as we won’t be able to help him.

My first thought would be prolonged service 99358 but no face to face will happen. Any thoughts would be appreciated.
 

lcolborn

Guru
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156
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Look into the Interprofessional Telephone/Internet/Electronic Record Consultations in the CPT book and see if it suits your question.
 

SharonCollachi

True Blue
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2,146
Location
Clovis, CA
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My reaction is that this is not a billable service. This was not your patient when the recs review was done, and no one requested your expertise on treating the patient (interprofessional).
 

BLUCIANI

Contributor
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15
Location
Mount Airy, MD
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0
Was the telephone call and the record review performed on the same day?
Who is the insurance provider?
We are still currently covered by the Presidential (PHE) Public Health Emergency 1135 Waiver Code 99441-99443 for a telephone E&M visit. Is communication with the patient audio only. (telephone) are applicable however, you need to be aware of the insurance billing policies some require that the E&M 99212-99214 /99202-99204 WITH A PLACE OF SERVICE CODE 02 and a TH modifier may also be used.
 
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