Question regarding the guidelines and documentation requirements for 99441-99443. Our providers are calling patients with lab/test results often. For example, we are drawing blood for PT/INR and sending the bloodwork to LabCorp. Once we get the results, the provider documents and calls the patient with the results. I understand the CPT codes specify these codes are to be used only when the patient initiates the call. What are some of the other offices doing to be able to bill this code for results of labs? I appreciate any help you have to offer.
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Wiki Telephone encounters
- Thread starter posborne@carolinaheartandleg.com
- Start date
Before expansion of telehealth (including video and audio here), this service was not billable. In my opinion, even with the expansion during PHE, this type of service is not separately billable. The work of giving the patient results is included in the order. For a patient with significant findings and a new treatment plan being developed, it would be understandable for a patient to have another visit to discuss this.
jkyles
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Yes, this question comes up from time to time and it isn't a separate service. The patient initiation requirement is the main barrier, as are the timing requirements.
But practices should also consider what they did before telephone E/M was an option. If they didn't routinely have patients come in for a separate visit for test results, then why bill for the telephone service? In addition to creating a noticeable change in billing behavior, it also creates a new copay obligation for patients, which they might not understand or appreciate.
But practices should also consider what they did before telephone E/M was an option. If they didn't routinely have patients come in for a separate visit for test results, then why bill for the telephone service? In addition to creating a noticeable change in billing behavior, it also creates a new copay obligation for patients, which they might not understand or appreciate.
amyjph
True Blue
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.