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Question Telephone E/M

Messages
109
Best answers
0
Hi, does anyone know if a nurse midwife can bill for a phone e/m? We have several claims and they're all denying. I appreciate any help!

Thanks!
 

ntreber

Networker
Messages
54
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0
What telephone codes as you billing? There are 2 sets of codes. One for Provider that bill E&M services and one for those who bill incident to.
 

jlcheritage

Contributor
Messages
15
Location
Shirley, NY
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0
telemedicine , you can code the appropriate E&M code with the modifier of 95. as of now I heard that you can still use the POS as 11. it does not have to be POS 02. However if you are giving a just telephone, then the 99441 to 99443 is appropriate.
 

wisibyusha

Networker
Messages
68
Location
Cordova, Tennessee
Best answers
0
The nurse midwives can bill for telehealth service as long as it is relevant to their practice and consistent with Medicare benefit rules. I am not sure which telehealth e/m code you are using. The 99441 -99443 which is telephone based e/m might require you to append the modifier 95. Also, the POS will be the one you would normally use before the Covid19.
hope that helps.
 

Mayzoo

Expert
Messages
386
Location
Tyler, TX
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0
telemedicine , you can code the appropriate E&M code with the modifier of 95. as of now I heard that you can still use the POS as 11. it does not have to be POS 02. However if you are giving a just telephone, then the 99441 to 99443 is appropriate.
Unless video was involved, my understanding is a phone call does not qualify as an E/M.
 
Messages
1
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0

wisibyusha

Networker
Messages
68
Location
Cordova, Tennessee
Best answers
0
Did you check your documentation? The total time should be documented. Also, you cannot use those codes if the telephone call is originated from the previous office visit of related e/m provided within the previous 7 days or lead to e/m service within the next 24 hours or soonest available appointment. During this pandemic the codes 99441-99443 might require mod. 95.
 

jlcheritage

Contributor
Messages
15
Location
Shirley, NY
Best answers
0
we have been denied for using the 95 on the codes 99441-99443. The description is that of telephone. so the modifier 95 lets the carrier know that it was a telemedicine visit.
 
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