Pulmonology Coding Alert

Question: A doctor interprets sleep studies in a hospital outpatient center. If he calls the patient to discuss the findings and to recommend further treatment, can he bill for this?

North Carolina Subscriber  
Answer: You can bill using telephone codes 99371-99373. Code 99371 (telephone call by a physician to patient or for consultation or medical management ...  simple or brief ...) is for a short phone call, usually to inform the patient of test results. Code 99372 ( intermediate ...) is used for a longer call when test results may be discussed in detail or advice provided.
 
Report 99372 for the above scenario because the physician most likely had to describe the results in detail as well as recommend further treatment. Code 99373 ( complex or lengthy ) is for a more extensive phone call, for example, a detailed discussion with family members about a seriously ill patient or to coordinate complex services. This code would not apply in this case.
 
Not all payers reimburse for telephone-call codes, so check with your commercial carrier before billing. Medicare considers these codes bundled into any other service provided and not separately payable. If you bill them and the insurer denies the claim, the patient may be responsible for the payment. Typically, physicians do not bill for these types of services.