Pediatric Coding Alert

Question: My provider habitually calls patients to tell them about their lab results. The pediatrician ordered the labs as part of an evaluation and management (E/M) service, which was considered when I established the level of medical decision making (MDM) for that first encounter. Can I bill for the phone call, even if all the provider does is communicate the results?

AAPC Forum Participant

Answer: No, you should not bill for the phone call. That’s considered double-dipping because, as you said, the labs were already counted (and therefore billed) with the E/M service. Interpreting those results is included, per the MDM table.

Remember too, that in order to report telehealth codes, the patient must initiate the call. To report instances where other services were provided during a phone call, first review the instructions for reporting telephone visits with your providers. To see a comprehensive chart that outlines the telehealth codes and requirements for each, take a look at the article titled “Strengthen Your telehealth Coding Game with These 4 Tips,” published in Pediatric Coding Alert Volume 26, Number 11.