 Telephone and On-line Services:
How Much Is Your Practice Losing?
As background, CPT 1995 introduced three codes to enable physicians
to charge for telephone management services. With the introduction
of these codes, I designed a Pocket Coding Pad to be used as
a tool by physicians to help capture these services and ensure
they were billed.
Nine years later in July, 2004, a Category III code was introduced
to allow physicians to also bill for on-line services. Category
III codes are temporary codes for emerging technology/services/procedures.
Naturally, I supported this code as well and added it to the
Pocket Coding Pad.
This year, CPT 2008 has readdressed telephone management and
on-line services. The old codes have been deleted and replaced
with more detailed descriptions of what the services entail and
the recommended time guidelines.
What is really significant is that in the past, only physicians
who were directly involved with these services could charge for
them. Now, CPT 2008 allows qualified non-physician healthcare
providers to bill for these services, too. The three deleted
codes (99371, 99372 and 99373) were described as brief, intermediate
and complex. The vague descriptors prompted many questions about
the utilization of the codes and necessary documentation to support
the services.
The new and revised codes for physicians are found in the
Evaluation and Management Section of CPT 2008 under "Non-Face-to-Face
Physician Services." Telephone management is now defined
as non-face-to-face evaluation and management provided by a physician
using the telephone. These codes are used to report episodes
of care by the physician when the care is initiated by an established
patient or guardian of the patient.
Telephone
Services:
99441 5-10 min.
99442 11-20 min.
99443 21-30 min. |
On-Line Medical
Evaluations:
99444 |
The new codes enabling qualified non-physician healthcare
providers to bill for telephone and on-line services are found
in the Medicine Section of CPT 2008 under "Non-Face-to-Face
Nonphysican Services."
Telephone
Services:
98966 5- 10 min.
98967 11-20 min.
98968 21-30 min. |
On-Line Medical
Evaluation:
98969 |
There are a few common sense limitations for utilizing the
codes and they are outlined in both sections referenced above:
1. If the call results in a decision to see the patient within
24 hours or the patient is scheduled for the next available urgent
care visit appointment, it is not billable because these services
are considered part of the preservice work for the subsequent
visit.
2. If the call refers to an evaluation and management service
performed by the physician or nonphysician healthcare professional
within the previous seven days, it is not billable as it is considered
part of the previous E&M service.
3. If the call from the patient is placed within the global
period of a past procedure, it is considered a part of the global
fee and therefore not billable.
With these guidelines established, there is much more clarity
on how and when to bill for telephone and on-line services.
Use the on-line medical evaluation codes to report on-line
services provided to an established patient, guardian or healthcare
provider. The same common sense parameters listed above for telephone
management apply to on-line services. Reportable services encompass
the sum of all communications pertaining to the on-line patient
encounter (such as telephone calls, prescriptions, etc.) and
require a hard copy of the encounter to be stored in the patient
chart.
All of the above supports the fact that telephone and on-line
patient management is a growing trend. More and more insurance
companies are reimbursing for these services and the reimbursement
amounts have continued to increase. Physicians should take advantage
of the codes provided to them by the AMA to receive the legitimate
reimbursement to which they are entitled.
Pocket Coding Pads - The Convenient Billing Tool for Capturing
Services. Now available for Physicians and/or Qualified Nonphysician
Providers.
|