Rely On These Codes When Reporting Portal Communication
Question: The primary care physician (PCP) I work for had a conversation with an established patient about a rash via the messaging system in our secure patient portal. The provider and patient exchanged four messages over three days, including the discussion of a photo of a rash on the palm of the patient’s hand and the provider’s diagnosis of hand, foot, and mouth disease. Can I report this conversation for reimbursement from the patient’s payer? Pennsylvania Subscriber Answer: There are digital evaluation and management (E/M) codes available for reporting such situations. You can look to the 99421(Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes) to 99423 (… 21 or more minutes) CPT® codes for reporting patient portal communications with an established patient. If your provider hasn’t documented the amount of time they’ve spent on this conversation, you can query the physician in order to select an accurate E/M code. As for the diagnosis code, look to ICD-10-CM code B08.4 (Enteroviral vesicular stomatitis with exanthem). Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC 
