Eli's Rehab Report

Question: I'm happy to see that we have new codes for telephone and online services (98966-98969), but I'm wondering what kind of advice we can give to patients over the telephone and what exactly we can bill for. Are these codes for giving medical advice?

Connecticut Subscriber

Answer: As a PT, OT, or SLP, you must watch your scope of practice when you're on the telephone with a patient. Giving "medical advice" would be more appropriately connected to a physician.

If you're simply looking for an example of what a therapist might say on the phone and then bill for, consider an example in CPT 2008 Changes: An Insider's View, which describes a 54-year-old female patient with a history of rheumatoid arthritis and metacarpophalangeal arthroplasties of her dominant hand. The patient calls her occupational therapist because of both postoperative pain and trouble using her dynamic outrigger orthotic. The OT makes sure the patient understands the instructions from her last office visit and offers further clarifications and recommendations regarding her exercises, positioning during the night, cold applications, etc.

Tip: Even though Medicare does not reimburse these codes right now, remember to keep track of your time on the phone and document what was discussed, as these are timed codes. You will want to be in this habit in the event that Medicare or other payers do decide to reimburse for these services.

-- Reader Questions were answered by Rick Gawenda, PT, director of PM&R at Detroit Receiving Hospital and owner of Gawenda Seminars.