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? for Family Practice coders

  1. Question ? for Family Practice coders
    Medical Coding Books
    I was wanting to find out if anyone charges for phone calls to patients to inform them of lab results.
    Example: A patient comes in for a blood draw with no office visit. Only the venipuncture is charged. Once the results are returned from the lab, the physician reviews them, decides on the course of treatment, informs the clinical staff to call the patient with the results and recommendations. At that time a Level I E/M would be charged for the physician's time reviewing the results and treatment decision.
    Is anyone doing this?
    Last edited by nc_coder; 12-02-2011 at 07:40 AM.

  2. #2
    Location
    Fayetteville, NC
    Posts
    300
    Default
    We have one physician who charges for phone calls but we use the CPT codes for "Telephone Services" (99441-99443). The codes require that the physician document time and requires the physician actually makes the call themself. There are guidelines for these codes which are clearly laid out in the CPT book.
    For nonphysician health care professionals the CPT says see 98966-98968.
    There are guidelines for the use of these codes listed above the codes themselves.
    Office visit level codes require face-to-face services therefore in my opinion a telephone call should not be coded with an office level code.
    Last edited by Grintwig; 12-02-2011 at 07:34 AM. Reason: Added a thought
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

  3. #3
    Location
    Columbia, MO
    Posts
    12,841
    Default
    You cannot bill the 99441-99443 codes if the physician initiates the phone call. These are for phone call services where the patient calls the office to ask a question etc. It cannot be billed if it is with in 7 days of the office encounter if it is related to the office encounter. You may not bill a 99211 for a phone call. The 99211 states physician need not be present but that means in the room with the patient, the patient must be face to face with a qualified medical person in the office to use the 99211 and then incident to parameters must be met. To call the lab results to the patient is part of the MDM on the visit where the tests were discussed and ordered. You cannot bill for the phone call to the patient either by physician or other persons int he office.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Location
    Evansville Indiana
    Posts
    451
    Default phone call
    I agree most definitely with Debra.
    LeeAnn

  5. Question
    Say the patient only comes in for the blood draw every 6 months for follow up, but does not come in for the office visits. The results are called to the patient and then they are told to come back for follow up labs in 6 months.

  6. #6
    Location
    Columbia, MO
    Posts
    12,841
    Default
    There is nothing to bill except the lab codes and the blood collection

    Debra A. Mitchell, MSPH, CPC-H

  7. Default Thank you.
    All of this was very helpful. Thank you for your replies.

  8. #8
    Location
    Macomb Township
    Posts
    11
    Smile Billing for Phone Calls
    The telephone codes 99441-99443 are for patient initiated phone calls, CPT does not recognize a phone call made from the physician office to the patient for lab results as a codable service. In that regard, I would agree with Debra's comments.

  9. Exclamation Follow up
    Ok- I have presented all of this to my office manager. I almost have her on-board with my way of thinking, but there are still answers to some of her questions that she wants backed up by credible sources. I am hoping someone can point me to some. Here is the issue now. I told her that from my understanding, the reporting of the lab results would be included in the original E/M service where the order for the labs was originated. I need to find something documented -BY A CREDIBLE SOURCE- to back that up. She goes by the old belief that if you put 3 coders in a room and give them the same scenerio, you will get 3 different interpretations. All of the documentation on the use of the 99211 says that if the lab results are reviewed at the time of the visit, when the patient is still in the office, and changes are made, you can bill the 99211. The problem with that in our office is that we send our labs to an outside lab. We do not have an in-office lab. Please help me. I love my job and the people I work with and I do not want to have to leave over this problem. But if I can't get the office manager and lead physician on-board with not billing this, I am afraid that is exactly what I will have to do.

  10. Default
    Try this - - we're dealing with the same thing.

    http://www.wpsmedicare.com/part_b/re...lab_test.shtml

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