Question Telephone E/M

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109
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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
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55
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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
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16
Location
Shirley, NY
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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
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69
Location
Cordova, Tennessee
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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
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398
Location
Tyler, TX
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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.
 
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wisibyusha

Networker
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69
Location
Cordova, Tennessee
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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
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16
Location
Shirley, NY
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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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