Pulmonology Coding Alert

Question: A provider had a telephone visit with a patient to refill prescriptions for the patient’s chronic conditions and help fill out disability forms, too. The provider documented the time spent with the patient as 83 minutes discussing the patient’s conditions and medication adjustments and 30 minutes helping the patient with the paperwork.

Can the provider bill for time spent with the patient?

Washington Subscriber

Answer: Unfortunately, the maximum time you can bill for a telephone evaluation and management (E/M) visit is 30 minutes. Therefore, you’ll assign 99443 (Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided 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; 21-30 minutes of medical discussion) to report the visit.

Even though the provider spent nearly two hours on the phone with the patient, they’re not going to be able to collect reimbursement for the minutes spent past the initial half hour.