Urology Coding Alert

Question: From his office an urologist reviews lab test results and, by telephone, orders additional testing and medication changes for nursing facility patients. Can the urologist charge for this work if the physician does not see the patient face-to-face? Can a nurse performing the same services from the office charge for these services as "incident to"?

Connecticut Subscriber

Answer: No. Without a face-to-face visit the urologist cannot charge for his telephone evaluation and orders. A nurse also cannot bill an "incident-to" service outside of the office. In this case, no direct face-to-face service occurred between the patient and the urologist/nurse, even though the urologist discussed over the phone with the patient's caregiver the results of tests and ordered further studies.

Good news: Your urologist may not be giving away his reviews/medical orders for free. E/M services include some related pre- and post-work time, so reviewing lab results might be included in a future related face-to-face nursing facility visit (such as 99307-99310, Subsequent nursing facility care, per day, for the evaluation and management of a patient ...).

Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, University Hospital, State University of New York, Stony Brook.