Gastroenterology Coding Alert

Discover new codes for medical team conferences Great news: For those gastroenterologists spending more time with patients on the phone or online, CPT 2008 has developed some new codes that may get you paid. Benefit: Although payers may not reimburse these new codes, they will allow physicians to bill the patient for these services in many instances and help the practice "better track the care being given by office providers," says Jennifer L. Lawrence, CPC, coder and billing manager of Westside Gastroenterologists Inc. in Middleburg Heights, Ohio. Welcome Easier Telephone Call Code Selection Deletion: When you report 99371-99373, you are saying your physician called a patient or coordinated medical management with other healthcare professionals, such as nurses or other physicians. CPT 2008 deletes these codes. Instead, you've got six new codes for telephone E/M care, and the length of the call will determine which code to pick: • 99441 -- Telephone evaluation and management service provided by a physician to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion • 99442 -- ... 11-20 minutes of medical discussion • 99443 -- ... 21-30 minutes of medical discussion • 98966 -- Telephone assessment and management service provided by a qualified nonphysician healthcare professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous seven days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion • 98967 -- ... 11-20 minutes of medical discussion • 98968 -- ... 21-30 minutes of medical discussion. Notice how 99441-99443 entails telephone E/M services involving a physician while 98966-98968 involves a qualified nonphysician healthcare professional. The nitty-gritty: Keep in mind, however, that you've got some rules to contend with. For instance, the new time-based telephone call codes will not only have a seven-day pre-global period but can also not result in an office visit within 24 hours, says national coding speaker Richard H. Tuck, MD, FAAP. To use these codes, keep in mind the following: • The patient or the established patient's guardian must initiate the contact. • Do not report the new codes if your gastroenterologist sees the patient for the problem within 24 hours of the call or at the next available urgent appointment. When this happens, you should consider the call part of the preservice work and count it as part of the billable E/M service. • Do not report the new codes if the call [...]