Wiki Reviewing Records

[dbouton]

My doctor wants to know, if there is a cpt code we can bill for the time he spends reviewing records from a referring provider prior to a new patient visit? I know there are codes if he contacts the referring provider to discuss care, but I am just not sure about reviewing records.

 

[Pathos]

Technically there are codes like that, however this task is commonly bundled into the E/M code. If your provider tries to bill the review of documents code, and also an E/M code, they are now unbundling the E/M code. Unbundling often results in a False Claim, which will negatively affect your provider and the practice.

 

[csperoni]

99358 and 99359 are specifically for prolonged E&M service WITHOUT direct patient contact. However, virtually every payor will not pay for this code. The minimum amount of time required reviewing the record is 31 minutes to use these codes. 31 minutes is really a long time to read records. I work in gynecologic oncology and we used to occasionally bill these codes, but discontinued using them when it caused every claim to get pended and resulted in no additional payment.

 

[dbouton]

Thank you guy's so much for the help!