Anesthesia Coding Alert

Question: Is there a code to report a phone conversation between a physician and a patient if no other services are provided on that date (the doctor does not provide face-to-face service for the patient)?

Washington Subscriber
 
Answer: Codes 99371-99373 are for telephone calls from physicians to patients or other health professionals when no other E/M service for the patient is provided on the same date. Therefore, if the physician (such as a pain management specialist) discusses information over the phone with a patient, and no face-to-face service is provided for the patient on that date of service, use the appropriate telephone-call code to identify the specific service provided. Payment guidelines for these codes vary by payer, so check with any third-party carriers for their policies (many carriers will not pay for phone consultations, so any reimbursement would come from the patient).
 
It is important to remember two things about non face-to-face call services with Medicare patients. First, these codes are status code B (for bundled services) rather than status code N (for noncovered services). Because they are bundled, you cannot attempt to receive payment from the patient for these services under any circumstances even if you obtain an advance beneficiary notice (ABN or waiver) beforehand. This is because Medicare considers payment for these non-face-to-face services included in your providers payment. Second, Medicare has indicated that any non-face-to-face services that take place between E/M visits are grouped with the previous E/M visit and could theoretically affect the E/M level selected for the earlier visit.