Pediatric Coding Alert

Question: A parent leaves a message seven days after the previous related E/M visit and wants phone care. Because the caller left the message on the office machine on a Sunday, we did not get the message until day eight. Can we bill for that phone call? Also, can I use a phone care code for a call that a pediatrician makes to the emergency department (ED)?

Codify Subscriber

Answer: In scenario one, you can report the phone call eight days after the related E/M service with the phone care codes (99441-99443, Telephone evaluation and management service provided by a physician to an established patient, parent or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment ...). Include related phone care that a pediatrician provides to a patient/ family member within seven days of the related E/M service.

Beware: Make sure you are not gaming the system by intentionally responding outside the time frame. As you indicate, you could not respond to the call within the seven days because you received the request when the office was closed.