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ED Coding and Reimbursement Alert

READER QUESTIONS:

Don't Count on 99371 for ED Service

Published on Mon Feb 28, 2005

Question: One of our physicians wants me to bill 99371-99372 for calls and consultations - for example, talking to the orthopedist about a patient's fracture care. Can we bill this along with 99281-99285?


Louisiana Subscriber

 
Answer: Reporting 99371-99372 (Telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other healthcare professionals [e.g., nurses, therapists, social workers, nutritionists, physicians, pharmacists] ...) probably isn't appropriate for these services, because the activities you describe are generally included in the emergency department E/M service.

Most payers do not pay for telephone calls. And the physician must meet the requirements for a consult before billing codes 99371-99372, which is highly unlikely in the ED.
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