Pediatric Coding Alert

Question: Does an Internet office visit trigger a copay?

Ohio Subscriber

Answer: Using 99444 (Online evaluation and management service provided by a physician to an established patient, guardian, or health care provider not originating from a related E/M service provided within the previous 7 days, using the Internet or similar electronic communications network) may make the patient responsible for a copayment. Often, copays for an Internet service are less than for an office visit. Copays for 99444 typically range between $0-$10.

Do this: Make sure that this "virtual visit" meets the following CPT requirements and that you code based on these guidelines:

1. The pediatrician responds to patient's e-mail inquiries in a timely manner.

2. Your practice permanently stores an electronic or paper copy of the encounter.

3. You report the episode of care only once even when it requires multiple exchanges -- even between multiple physicians.

4. The encounter is not related to an E/M service that your group performed and reported within the previous seven days or within the postoperative period of the previously completed procedure.

5. Include any related telephone calls, prescription provision, and laboratory orders in 99444.