Pediatric Coding Alert

Question: Should pediatricians bill for telephone calls they make during attention deficit hyperactivity disorder (ADHD) evaluation services?

Wisconsin Reader

Answer: You can report phone calls with codes 99371-99373, but some pediatricians do not want to charge as a matter of maintaining good patient relations. You can also bill for phone calls as part of the non-face-to-face prolonged services before or after the face-to-face encounter the day of the visit.

Typically, payers do not reimburse for telephone calls, but pediatricians should check with payers concerning calls made as part of case management for complicated problems such as ADHD. On the other hand, you can tell parents they will have to pay out of pocket for this if it is not covered by insurance. Advise parents up front about possible phone calls and anticipated charges.

Answers to Test Yourself and the Reader Question were provided by Mary I. Falbo, MBA, CPC, president of Millennium Healthcare Consulting Inc. in Lansdale, Pa.; and David Horowitz, MD, FAAP, practicing pediatrician with Triangle Pediatric Center in Cary, N.C., and chairman of the mental-health committee of the North Carolina Pediatric Society.