Pediatric Coding Alert

Question: Our doctor spent a long time on the phone with a patient’s mother discussing the patient’s ADHD and anxiety. We billed 99339 (Individual physician supervision of a patient [patient not present] in home, domiciliary or rest home…). Is that correct?

Answer: Your payer will probably not accept 99339 for this. You should use 99339 to describe the work a doctor provides on a regular basis while performing frequent complex supervision services to a patient in a home, domiciliary or rest home including:

• regular physician development and/or revision of care plans
• review of subsequent reports of patient status
• review of related laboratory and other studies
• communication (including telephone calls) for purposes of assessment or care decisions with healthcare professional(s), family member(s), surrogate decision-maker(s) (e.g., legal guardians), and/or key caregiver(s) involved in a patient’s care
• integration of new information into the medical treatment plan and/or adjustment of medical therapy.

Therefore, this code will not justify your physician’s time on the phone with the patient’s mother.