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Coding Phone consultations

  1. #1
    Location
    Albuquerque,NM
    Posts
    59
    Default Coding Phone consultations
    Medical Coding Books
    I have been billing them and having the PT fill out a release for saying that this is not a covered benefit and they the will be charged this fee. I need to know if I append a modifier .

  2. #2
    Default
    Quote Originally Posted by lopezk89 View Post
    I have been billing them and having the PT fill out a release for saying that this is not a covered benefit and they the will be charged this fee. I need to know if I append a modifier .
    Careful to make sure your documentation meets the criteria for the CPT code - If the patient is told to come in and see the doctor within the next 24 hours, or the next available urgent care visit appointment, or if the call is related to a previous E/M reported within the past 7 days, it's not billable at all. Billing a patient for a service in those circumstances would be a violation of your contracts - it's as good as unbundling and balance billing the patient for the incidental work.

    That said, if you're billing Medicare, you have to have a real ABN signed, and you'd use the appropriate HCPCS modifier, either GA, or GX if they refused to sign.

    Commercial will not require a modifier, but expect to have medical records requested for the encounter. Hope that helps!

    Cute pic, by the way...

  3. #3
    Location
    Albuquerque,NM
    Posts
    59
    Default Hello
    Yes Thank you very Much !!!!!
    And thank you Yours is pretty cute as well.....

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