Internal Medicine Coding Alert

Question: Our nurses usually give lab results to patients and call in prescriptions to the pharmacy. Can we use CPT codes 99371-99373 for the nurses' calls?

Tennessee Subscriber

Answer: No. Those codes are for use by physicians for case management of patients and cannot be used by nurses or other assistants and cannot be reported for calling in a prescription.

If the doctor calls the patient with lab results, you may use a code in this series. However, the physician must call the patient (not vice versa) for these codes to apply.

Use 99371 (Telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other health care professionals [e.g., nurses, therapists, social workers, nutritionists, physicians, pharmacists]; simple or brief [e.g., to report on tests and/or laboratory results, to clarify or alter previous instructions, to integrate new information from other health professionals into the medical treatment plan, or to adjust therapy) for a simple telephone call.

Use 99372 for a call of intermediate complexity, e.g., providing advice to an established patient on a new problem or discussing test results in detail, and use 99373 for complex or lengthy services, e.g., counseling an anxious or distraught patient for a long period or discussing a seriously ill patient at length with family members.

However, Medicare and many private insurers will not reimburse for these codes. They are considered bundled with any other service that has been provided to the patient at any time.

Answer to You Be The Coder was provided by Linda Parks, MA, CPC, lead coder at Atlanta Gastroenterology Associates, a 23-physician practice. Answers to Reader Questions were reviewed by Kathy Pride, CPC, CCS-P, HIM applications specialist with QuadraMed, a national healthcare information technology and consulting firm based in San Rafael, Calif.; Jim Stephenson, president of North Central Medical Management, which provides coding, billing and medical management services to practices in Ohio and West Virginia; and Catherine Trinidad, CPC, certified coder for Community Health Center Network, a network of seven community health centers in Alameda County, Calif.