Podiatry Coding & Billing Alert

Question: A new patient came to our office, and the physician did a complete workup, resulting in a level-three new patient E/M visit. Later in the week the doctor called the patient to see how he was doing and to discuss questions the patient had. He spent 22 minutes on the phone with the patient. The doctor thinks since there are telephone codes, we should report them. I don't think this is a billable service. Who is correct?

Delaware Subscriber

Answer: You are correct. CPT offers three telephone service codes:

• 99441 -- 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; 5-10 minutes of medical discussion

• 99442 -- ... 11-20 minutes of medical discussion

• 99443 -- ... 21-30 minutes of medical discussion.

Although reporting 99443 might seem like the right choice because the physician spent 22 minutes on the phone discussing the patient's care, the code descriptors for these codes specify that  you cannot report 99441-99443 within seven days of an E/M service. Therefore, you cannot bill for this telephone call.

Pointer: You can consider the telephone conversation between a provider and patient as a factor when determining a service level for any follow-up related E/M service -- if your physician's documentation showed how the telephone conversation affected the key components of history, exam, and medical decision making for the future E/M service. You can fold the phone call time into the medical decision making (MDM) for the follow-up service.

-- Answers to You Be the Coder and Reader Questions were provided and/or reviewed by Richard D. Odom, DPM, CPC, a podiatrist in Spanish Fort, Ala and Arnold Beresh, DPM, CPC, of Peninsula Foot and Ankle Specialists PLC in Hampton, Va.