Orthopedic Coding Alert

Question: My orthopedist sent a patient with osteomyelitis to the hospital for IV therapy. He would like to know: Is there any way that he may be paid for all the work involved in sending these patients to the hospital for IV therapy. It is a 10-course of antibiotics. It takes a lot of time for him to do this. He must write orders, review lab cultures, etc. He said it is starting to take 2-3 hours of his time. He does not admit the patients. They go into the hospital, have their antibiotic IV, and then go home. If there is a way to get paid, what code would he use?

Answer: Unfortunately, with no face-to-face encounter with the patient there is really nothing billable for the orders and lab reviews. It is possible that your orthopedic surgeon could include the work he does toward the overall level for his next face-to-face encounter with the patient, or in the most recent visit where the decision was made to send the patient for IV therapy if that has not been billed yet. But that will depend on your payer and can get complicated if auditors review your records. Alternatively, there are CPT® codes for prolonged non-face-to-face services (99358-99359), but these codes are rarely paid by insurers.