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Is There a CPT Code For This Scenario?

  1. #1
    Default Is There a CPT Code For This Scenario?
    Medical Coding Books
    We had a patient that was admitted from the ER into PICU this weekend. Several calls were made between the ER/PICU docs and our doc, all initiated by the ER/PICU docs. Our doc spent a lot of time on the phone this weekend and would like to be able to charge for it. Is there a code that can be used for telephone time between pysicians discussing patient care?

    Thanks for any advice.
    Lainie, CPC

  2. Default
    Quote Originally Posted by lstuder View Post
    We had a patient that was admitted from the ER into PICU this weekend. Several calls were made between the ER/PICU docs and our doc, all initiated by the ER/PICU docs. Our doc spent a lot of time on the phone this weekend and would like to be able to charge for it. Is there a code that can be used for telephone time between pysicians discussing patient care?

    Thanks for any advice.
    Lainie, CPC
    Hi,
    The ER doctors can bill for those telephonic calls and not the PICU doctors.

  3. Default
    Quote Originally Posted by lstuder View Post
    We had a patient that was admitted from the ER into PICU this weekend. Several calls were made between the ER/PICU docs and our doc, all initiated by the ER/PICU docs. Our doc spent a lot of time on the phone this weekend and would like to be able to charge for it. Is there a code that can be used for telephone time between pysicians discussing patient care?

    Thanks for any advice.
    Lainie, CPC
    Check CPT Code 99367. If this is a Medicare patient I don't think they will pay for thsi code.

  4. #4
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    Milwaukee WI
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    4,466
    Default NOT medical team conference
    The guidelines for Medical Team Conferences contain this statement:
    "Medical team conferences includes face-to-face participation by a minimum of three qualified health care professional from different specialites or disciplines .."

    The patient does not need to be present for CPT 99367, but at least 3 medical team members from different specialties must be face-to-face.

    The time spent on phone calls between the PICU docs and your doc (as long as the calls were made from the PICU) can be counted in the total critical care time for the PICU doctor. But that doesn't help your doc ...

    You could try the 99499 Unlisted E/M, ... you'll have to submit documentation, and I doubt you'll get paid for this by any carrier.

    I know your doc spent time on these multiple calls, and it's frustrating not being able to code these types of services. But s/he might want to consider how the parents will feel getting a bill for "phone calls" when their child is so ill.

    There's just no "good" answer to this one, I'm afraid.

    F Tessa Bartels, CPC, CPC-E/M
    Last edited by FTessaBartels; 08-26-2008 at 02:41 PM.

  5. #5
    Smile Thanks
    Tessa,

    That's the conclusion I came to as well. Thanks for the help.

    Lainie

  6. Default
    Quote Originally Posted by FTessaBartels View Post
    The guidelines for Medical Team Conferences contain this statement:
    "Medical team conferences includes face-to-face participation by a minimum of three qualified health care professional from different specialites or disciplines .."

    The patient does not need to be present for CPT 99367, but at least 3 medical team members from different specialties must be face-to-face.

    The time spent on phone calls between the PICU docs and your doc (as long as the calls were made from the PICU) can be counted in the total critical care time for the PICU doctor. But that doesn't help your doc ...

    You could try the 99499 Unlisted E/M, ... you'll have to submit documentation, and I doubt you'll get paid for this by any carrier.

    I know your doc spent time on these multiple calls, and it's frustrating not being able to code these types of services. But s/he might want to consider how the parents will feel getting a bill for "phone calls" when their child is so ill.

    There's just no "good" answer to this one, I'm afraid.

    F Tessa Bartels, CPC, CPC-E/M

    Good morning

    I came across your post on team conferences and I was hoping that maybe you can help me find an answer. In regards to CPT 99367 can a physician call in to the team conference (granted that all other requirements are met in the definition of 99367). Thank you and I hope you have a great day!

    Love Coding!

  7. Default Interprofessional consultation
    Quote Originally Posted by lstuder View Post
    We had a patient that was admitted from the ER into PICU this weekend. Several calls were made between the ER/PICU docs and our doc, all initiated by the ER/PICU docs. Our doc spent a lot of time on the phone this weekend and would like to be able to charge for it. Is there a code that can be used for telephone time between pysicians discussing patient care?

    Thanks for any advice.
    Lainie, CPC
    Update - I forgot to add that the consultant must provide a written report and should not have seen the patient in a face-to-face encounter within the last 14 days or scheduled an appointment within 14 days. See the prefatory instructions in CPT for more.

    If the requests for information and time of each call was documented in addition to the topics discussed/advice given, etc., this may qualify as interprofessional consultation 99446-99449. Though not covered by all payers, these adequately describe one physician consulting another by telephone or internet. For subspecialists who are often contacted by other physicians for advice or opinion, these codes are worth negotiating. Hope that helps.

    Cindy
    Last edited by Cynthia Hughes; 03-01-2018 at 01:32 PM.

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