Otolaryngology Coding Alert

Society supports payers reimbursing telephone care

If you choose to bill for allergist-made telephone calls, you now have solid backing for your position. The American Academy of Pediatrics (AAP) recently released a statement advocating physicians charging and payers reimbursing for these services. Surveys show the increasing burden of telephone care. Consider these tips for rethinking your telephone policy. Tip 1: Consider Charging Acceptable You may have been reluctant to charge for telephone calls--just like form completion--for fear of alienating parents, causing them to leave your practice. -Yet, anecdotal reports suggest that many of these fees have become commonplace in offices across the country without patient exodus,- the AAP says in its -Policy Statement: Payment for Telephone Care.- The AAP also argues against two reasons physicians give for not charging for this work: 1. You may have -ethical concerns that billing for telephone care may create a barrier to healthcare access and deter poor families from calling with serious problems,- the AAP says. But this same concern applied to and was unfounded when copayments were first introduced. In fact, because the U.S. has a market-driven system, justifying giving this service for free is actually harder to support. The AAP instead recommends that citizens and policy-makers debate this issue. 2. Are you worried that charging for telephone calls will place a financial burden on the nation's healthcare system? Actually, telephone care can avoid higher-costing ED and office visits--reducing, rather than increasing, medical expenses, the AAP says. Tip 2: Learn Code Categories Physicians cannot continue to bear the enormous cost of telephone care, says Joel Bradley Jr., MD, with Premier Medical Group in Clarksville, Tenn. -We must learn to recover our costs by using telephone-call codes,- he says. You may shy away from using telephone-call codes 99371-99373 due to their lack of time allotments. Select the appropriate code based on the level of work, Bradley says. Think of the codes this way: Code Level of work                                      Examples 99371 Simple or brief                                       Report on tests, clarify instructions, adjust therapy 99372 Intermediate                                          Advice on a new problem, initiate therapy, discuss tests in detail 99373 Complex                                               Lengthy counseling session, detailed or prolonged discussions regarding serious illness Tip 3: Document These Phone Details Thorough notation is key when reporting telephonecall services. -Documentation should fulfill the need for continuity of care, demonstrate the complexity of the call, and meet the requirements of the typical E/M visit,- the AAP states. Bradley suggests including these documentation items: - the time spent on the call - a general note about the encounter's content including the key elements of history and medical decision-making. Don't forget: To demonstrate the expertise required and the complexity of the decision-making process, the AAP suggests that -the physician [...]