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Question re: 99371-99372

kfc

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Our clinic has patients that call for a rx but they do not want\can't come to the office. Is there any way we can code the 99371-99372 and get paid for this service. We have billed this procedure to Medicare in the past and they have denied but on the other hand we have billed it to DSHS and been paid (2007). Is there a secret to these procedure codes? Any input would be great!!!
 

LisaVel

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Lisa Velasquez,CPC

The reason you were unable to find the accurate code is because for 2008, CPT's 99371, 99372 and 99373 were changed to the following new codes 99441, 99442 and 99443. Hope this helps.
 

oh207

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Effective January 1, 2008, CPT added new time-based codes for reporting telephone care. These new codes are used when an established patient seeks advice or treatment for a problem that does not require a face-to-face visit.

The old codes for telephone care (99371-99371) have been deleted from CPT. New codes for telephone care are 99441,99442 and 99443.

Medicare has assigned RVUs and pricing for these new codes, and has announced that they are designated as Non-Covered for 2008.
Because these are noncovered services under the Medicare physician fee schedule, the physician or nonphysician practitioner may bill the beneficiary directly for these services as defined inthe CPT, at his/her established rate. Although an ABN is not required, CMS strongly encourages providers to issue the voluntary “Notice of Exclusion from Medicare Benefits (NEMB) so patients can make informed decisions in these situations. Information about
these notices can be found at:
http://www.cms.hhs.gov/BNI/11_FFSNEMBGeneral.asp#TopOfPage. CMS reminds providers that to be billable to the beneficiary the service must not be related to an E/M visit and must meet every part of the CPT definition and must be documented in the patient’s record.
 

GinnyMCCD

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Colonie, NY
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Code 99442

Can a nurse or MA be the caller for this code 99442 or does it have to be a Doc PA NPA? I read it as a provider code and a rep here is saying a nurse and MA can perform this and it is payable:confused:
 
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