Wiki CPT 99422 Clarification

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pudge2465@yahoo.com

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I have a provider that wants to bill CPT 99422 to answer a simple question from a patient. Example: "Can you refill my Lisinopril." And he answers back. No other documentation. I don't agree. Please help with clarification.
Thank you!
Myra
 
Go back to the CPT guidelines at the beginning of the 99421-99423 section. Read the description, does it meet the definition/guidelines? Did it take 11-20 minutes? Was the time documented? What was documented? If the answer is no, it is not reported.


Key points (there are more requirements):
Patient-initiated
Requires Physician or QHP evaluation, assessment, and management of patient.
Not for nonevaluative communication of test results, appointment scheduling, or other communication that does not include E/M.
Established patient.
Cumulative over a 7 day period.
Requires permanent documentation and storage of encounter.
Time must be documented.
Do not report for less than 5 minutes time.

There are multiple parenthetical notes with these codes and other requirements.
 
amyjph said:
Go back to the CPT guidelines at the beginning of the 99421-99423 section. Read the description, does it meet the definition/guidelines? Did it take 11-20 minutes? Was the time documented? What was documented? If the answer is no, it is not reported.


Key points (there are more requirements):
Patient-initiated
Requires Physician or QHP evaluation, assessment, and management of patient.
Not for nonevaluative communication of test results, appointment scheduling, or other communication that does not include E/M.
Established patient.
Cumulative over a 7 day period.
Requires permanent documentation and storage of encounter.
Time must be documented.
Do not report for less than 5 minutes time.

There are multiple parenthetical notes with these codes and other requirements.
Click to expand...
Perfect. Thank you!
 
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