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Thread: Can the doc charge for this?

  1. #1

    Default Can the doc charge for this?

    AAPC: Back to School
    I have a urology doc who called and spoke with the wife of a new patient to inform her that he would not be able to perform a schedule shockwave procedure on her husband's stone due to him breaking his arm in a skiing accident. They ended up speaking for 45 minutes discussing transition duties. He is trying to charge a consult (which he can't since the pt has Medicare) and also a 99443 for the phone call. That CPT code is only for an established pt though. Is there anything at all the doc can bill for his time?

    Thank you for your help!

    Lori, CPC

  2. #2


    You are saying the doctor never saw the patient?

  3. #3

    Default Re:

    Lesainc - Exactly...I talked to the girl who does his billing and she said he's never seen this patient before. I'm not sure he can charge anything for a phone call to a new patient. It was not a face-to-face visit.

    Lori, CPC

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    No there is nothing that can be charged since this is not an established patient. The 99443 is for a call initiated by the patient to speak with the doctor. and 99358 is to be used either after a patient encounter or before a patient encounter. You might look at it and see if it will fit but I am not thinking so.

    Debra A. Mitchell, MSPH, CPC-H

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