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e/m times multiply?

  1. #1
    Default e/m times multiply?
    Medical Coding Books
    So, if a call takes 75 minutes, how do you bill? Can you use a code x2, or x3?

    Per the CPT book, these times apply:

    99441 TELEPHONE CALL 5-10min


    99443 TELEPHONE CALL COMPLEX 20-30 min

    can i bill out 99443 x3???

  2. #2
    They spent 75 minutes on the phone and didn't see the patient within the previous 7 days or 24 hours after the call?

    I have yet to get my providers to document their phone calls so I haven't billed this out yet. I don't think units would be appropriate since this is an E/M code though.

    Just my opinion,

    Laura, CPC, CEMC

  3. #3
    that's what i thought also, but my provider kind of feels cheated...she wants some kind of supporting documentation stating that she can't bill the units since everything documented states these codes are dependent on time

    "Codes 99441–99443 are time-based codes for telephone services that are initiated by an established patient and delivered more than seven days from the last E/M service. If the telephone service results in a decision to see the patient within 24 hours, the code is not reported."

    taken from:

    And yes, she spent that time on the phone with the patient since the patient was on vacation. The patient was not seen again in the office until 10 days after the phone consult even though the patient returned from vacation 7 days after the phone service. (pt was seen 2 weeks before her vacation)
    Last edited by mad_one80; 09-08-2009 at 11:56 AM. Reason: added link

  4. #4
    Columbia, MO
    I understand your position but the codes are specific to the time aloted in the description and may not be billed as multiple units, anyting over the 30 minutes is not billable.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    THANKS as I stated before, I TOTALLY AGREE!! But the problem lies with explaining it to the doctor. She wants to be paid for the whole 75 mins!

    I guess the only thing I can really tell her is that unless it's an add-on code for E/M, no units are applicable. wish me luck!!!

    again, thanks both of you for confirming my thoughts on this!!!

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