non face to face

[krssy70]

Does anybody know if you can use the Prolonged Service for non face-to-face telephone consult with no follow-up appointment but is for ongoing pt management.
Thanks for any input!!!

 

[aguelfi]

Look at 99358-99359 and see if your documentation meets the requirements.

 

[krssy70]

Those are the codes sets that I was referring too. I apologize for not adding them into my questions. I have read the guidelines, but I was wondering if anybody has used those codes for telephone consults?

 

[LLovett]

So the consult itself was over the phone and there was no face to face contact, am I reading that correctly?

If so then no you can't use these codes, 99358-99359 are after face to face care only.

Laura, CPC, CPMA, CEMC

 

[krssy70]

I apologize once again...the provider has already seen the patient and this phone call was due to lab results and coordination of care, questions were answered that were addressed by the patient, and the call lasted for 30 minutes. I should of never used the word CONSULT...oops, my fault..

 

[LLovett]

Check out 99441-99443.

Laura, CPC, CPMA, CEMC

 

[dballard2004]

You can only report the telephone codes if the patient is established and the patient initiates the phone call. Also, it can't be related to an E/M within the previous seven days.

 

[RebeccaWoodward*]

I apologize once again...the provider has already seen the patient and this phone call was due to lab results and coordination of care, questions were answered that were addressed by the patient, and the call lasted for 30 minutes. I should of never used the word CONSULT...oops, my fault..

30.4 - Payment for Review of Laboratory Test Results by Physician
(Rev. 1, 10-01-03)
B3-5114.2

Reviewing results of laboratory tests, phoning results to patients, filing such results, etc., are Medicare covered services. Payment is included in the physician fee schedule payment for the evaluation and management (E and M) services to the patient. Visit services entail a wide range of components and activities that may vary somewhat from patient to patient. The CPT lists different levels of E and M services for both new and established patients and describes services that are included as E and M services. Such activities include obtaining, reviewing, and analyzing appropriate diagnostic tests.

http://www.cms.hhs.gov/manuals/downloads/clm104c16.pdf

 

[dballard2004]

I could not agree more! I have seen way to many providers who phone patients with the lab results and try to justify it with a telephone call code. Unbelievable.