Optometry Coding & Billing Alert

Question: A new patient with blurry vision came to our office on Wednesday. I did a complete workup, resulting in a level-three new patient E/M visit. Three days later, I called the patient to see how he's doing, to discuss questions the patient had and to recommend a follow-up appointment. I spent 17 minutes on the phone with the patient. Should we report a code for the telephone service?

New York Subscriber

Answer: No. CPT 2008 introduced three new telephone service codes:

Although reporting 99442 might seem like the right choice because you spent 17 minutes on the phone discussing the patient's care, the code descriptors for these codes specify that you cannot report 99441-99443 within seven days of an E/M service. Therefore, you cannot bill for this telephone call.

Pointer: You can consider the telephone conversation between a provider and patient as a factor when determining a service level for any follow-up related E/M service -- if your documentation showed how the telephone conversation affected the key components of history, exam and medical decision-making for the future E/M service.