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nc_coder

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I was wanting to find out if anyone charges for phone calls to patients to inform them of lab results.
Example: A patient comes in for a blood draw with no office visit. Only the venipuncture is charged. Once the results are returned from the lab, the physician reviews them, decides on the course of treatment, informs the clinical staff to call the patient with the results and recommendations. At that time a Level I E/M would be charged for the physician's time reviewing the results and treatment decision.
Is anyone doing this?
 
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We have one physician who charges for phone calls but we use the CPT codes for "Telephone Services" (99441-99443). The codes require that the physician document time and requires the physician actually makes the call themself. There are guidelines for these codes which are clearly laid out in the CPT book.
For nonphysician health care professionals the CPT says see 98966-98968.
There are guidelines for the use of these codes listed above the codes themselves.
Office visit level codes require face-to-face services therefore in my opinion a telephone call should not be coded with an office level code.
 
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You cannot bill the 99441-99443 codes if the physician initiates the phone call. These are for phone call services where the patient calls the office to ask a question etc. It cannot be billed if it is with in 7 days of the office encounter if it is related to the office encounter. You may not bill a 99211 for a phone call. The 99211 states physician need not be present but that means in the room with the patient, the patient must be face to face with a qualified medical person in the office to use the 99211 and then incident to parameters must be met. To call the lab results to the patient is part of the MDM on the visit where the tests were discussed and ordered. You cannot bill for the phone call to the patient either by physician or other persons int he office.
 
Say the patient only comes in for the blood draw every 6 months for follow up, but does not come in for the office visits. The results are called to the patient and then they are told to come back for follow up labs in 6 months.
 
Billing for Phone Calls

The telephone codes 99441-99443 are for patient initiated phone calls, CPT does not recognize a phone call made from the physician office to the patient for lab results as a codable service. In that regard, I would agree with Debra's comments.
 
Follow up

Ok- I have presented all of this to my office manager. I almost have her on-board with my way of thinking, but there are still answers to some of her questions that she wants backed up by credible sources. I am hoping someone can point me to some. Here is the issue now. I told her that from my understanding, the reporting of the lab results would be included in the original E/M service where the order for the labs was originated. I need to find something documented -BY A CREDIBLE SOURCE- to back that up. She goes by the old belief that if you put 3 coders in a room and give them the same scenerio, you will get 3 different interpretations. All of the documentation on the use of the 99211 says that if the lab results are reviewed at the time of the visit, when the patient is still in the office, and changes are made, you can bill the 99211. The problem with that in our office is that we send our labs to an outside lab. We do not have an in-office lab. Please help me. I love my job and the people I work with and I do not want to have to leave over this problem. But if I can't get the office manager and lead physician on-board with not billing this, I am afraid that is exactly what I will have to do.
 
Thank you.

Thank you for that link. I was aware of all of the information in the link. It still does not answer exactly what we are to do since our lab is not in-house. The physician has no way of reviewing the results while the patient is still in the office. We have to wait for the results to come back from the outside lab. Then if there is an issue that needs to be addressed, the physician feels he should be paid for the time reviewing the results and coming up with a new treatment. I have stated my case of the only way to do that is to have the patient come back in for a visit. I need something to support that fact and specifically addressing the outside lab issue.
 
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