Neurosurgery Coding Alert

Question: I-ve heard that we can charge insurance for our physician's online consultations, such as e-mails to patients that replace after-hours phone calls. How should I code for this?


Tennessee Subscriber

Answer: You can bill for electronic communications with your established patients using 0074T (Online evaluation and management service, per encounter, provided by a physician, using the Internet or similar electronic communications network, in response to a patient's request, established patient). CPT released 0074T in July 2004 as a category III code.

Good news: Some insurers have already agreed to pay up to $25 for each claim with 0074T. For instance, Blue Shield of California and BCBS of Tennessee reimburse for online E/M services. These insurers maintain their own coverage guidelines. Other payers, such as Medicare and Medicaid, do not yet cover these services.

Important: According to CPT guidelines, if you report 0074T, you must permanently store the records. CPT's notes describing an online medical evaluation (0074T) state that the services -must involve permanent storage (electronic or hard copy) of the encounter.-

If you don't have an electronic medical record that can import your e-mail files, you may want to print out copies of all e-mail correspondence and keep it in the physical record to ensure continuity of care. In addition, you should include in your documentation all communication with the patient, including telephone calls, prescriptions, and laboratory orders pertaining to the encounter.