Oncology & Hematology Coding Alert

Don't get too excited about some of the new evaluation and management codes in CPT 2008, because CMS doesn't share your enthusiasm.

Medicare won't cover new telephone and online E/M codes 98966-98969 and 99441-99444 at all. The services aren't face-to-face, and the codes include services to people other than the patient, such as the patient's guardian, CMS says in the 2008 physician fee schedule final rule.

This is yet another example of the old adage "Just because there is a code, does not mean you will be paid," says Barbara Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CHCC, director of outreach for the American Academy of Professional Coders in Salt Lake City.

Medicare constantly pushes physicians to "embrace technology" -- then refuses to pay for phone and online E/M visits, Cobuzzi says. "It costs money to offer e-services to make sure they are HIPAA-secure," and physicians are unlikely to spend that money if Medicare won't cover them.

"Dealing with patients via electronic means gives the physicians the much-needed time they need to see other patients and do paperwork," says Suzan Hvizdash, CPC, physician educator for the University of Pittsburgh Physicians department of surgery. Dictating whether the physician has to see the patient face-to-face shouldn't be up to the government.

Also, new medical team conference codes 99366-99368 will have a "bundled" status because CMS believes they-re included in existing E/M codes.

With patients living longer and having more complex problems, Medicare paying for these codes would make more sense, Hvizdash says. "Being able to meet with colleagues to discuss a patient's care is of major benefit to the patient and the insurance companies," she says.

More and more multi-disciplinary conferences are taking place, says Marcella Bucknam, CPC, CCS-P, CPC-H, CCS, CPC-P, CPC-OBGYN, CPC-CARDIO, manager of compliance education with the University of Washington Physicians. The conferences help make sure everybody understands the patient's care plan. But it's "almost impossible" to code for these conferences using standard E/M codes, she says.

For more information on the new E/M codes, see "Look for Debut of Online, Phone E/M Codes" in Vol. 10, No. 1 of Oncology & Hematology Coding Alert.