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Wiki Phone call visit
- Thread starter sathiya
- Start date
TThivierge
True Blue
Hi Sathiya
No cannot bill together per CPT manual year 2023 pg 27. The CPT 99441 is 5 minutes of phone call and CPT 99358 is prolong face to face over 30 minutes. If phone call and up to 30 minutes & phone call bill 99443 . I hope provider added minutes in documentation for the day and for established patient or not valid...per CPT manual .
Ok hope helped you
Lady T
No cannot bill together per CPT manual year 2023 pg 27. The CPT 99441 is 5 minutes of phone call and CPT 99358 is prolong face to face over 30 minutes. If phone call and up to 30 minutes & phone call bill 99443 . I hope provider added minutes in documentation for the day and for established patient or not valid...per CPT manual .
Ok hope helped you
Lady T
juliedogra86
New
My provider is also asking to use CPT 99214 with 93 modifier, but I explained if it's by phone call only and not with video included (like modifier 95) according to CPT 2023 we cannot billing 99214-93 and would instead bill 99443-93. However I know the rate of reimbursement is lower for the phone call. Has anyone else been able to bill 99214-93 or any of the other established patient codes (99211, 99212, 99213, 99214, 99215)? We are a Mental Health practice so I could bill at the psychotherapy rate of 90832-93 instead but i wanted to check about the E/M codes?
TThivierge
True Blue
Hi Julie
If basically a MH practice the therapist(LPC LCSW QHP) cannot bill Evl Mgnt codes with modifier 93 or 95. Only your psychiatrist, NP, PA or MD = doctor status can do Beh Health CPT and Eval Mgnt CPT. However they should discuss medical issue patient may suffer with such as dx E11, J44, I10 Etc to use Eval Mgnt CPT codes.. This must be noted in the medical documentation and minutes on this section of illness. Then part of med record minutes add to discussion Dx F32, F33, F10 Etc which applies to patient 's mental problems.
I hope this data helps you
Lady T
If basically a MH practice the therapist(LPC LCSW QHP) cannot bill Evl Mgnt codes with modifier 93 or 95. Only your psychiatrist, NP, PA or MD = doctor status can do Beh Health CPT and Eval Mgnt CPT. However they should discuss medical issue patient may suffer with such as dx E11, J44, I10 Etc to use Eval Mgnt CPT codes.. This must be noted in the medical documentation and minutes on this section of illness. Then part of med record minutes add to discussion Dx F32, F33, F10 Etc which applies to patient 's mental problems.
I hope this data helps you
Lady T
Hi Thivierge,
Thank you for the response. ya we can bill CPT 99443 if the phone call lasted more than 30 minutes but need to know if the provider spoke to the patient for 10 minutes review the patient reports for 30 minutes and prepared the appeal or auth letter for the patient's ongoing treatment for 20 minutes. Totally the provider spent (10+30+20) non face to face in this situation can we bill CPT 99358.
Thank you for the response. ya we can bill CPT 99443 if the phone call lasted more than 30 minutes but need to know if the provider spoke to the patient for 10 minutes review the patient reports for 30 minutes and prepared the appeal or auth letter for the patient's ongoing treatment for 20 minutes. Totally the provider spent (10+30+20) non face to face in this situation can we bill CPT 99358.
jkyles
True Blue
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Hi there, under your scenario you would only report 99441. You can't report 99358 for work the provider performs on the same day as the E/M visit. The guidelines for 99358 are spelled out in CPT manual.