Wiki Telephone E/M

[Shortcakecoder101]

Hi, does anyone know if a nurse midwife can bill for a phone e/m? We have several claims and they're all denying. I appreciate any help!

Thanks!

 

[ntreber]

What telephone codes as you billing? There are 2 sets of codes. One for Provider that bill E&M services and one for those who bill incident to.

 

[Mariefonseca]

telephonic codes are different from E/M, see 99441 to 99443

Thanks

 

[jlcheritage]

telemedicine , you can code the appropriate E&M code with the modifier of 95. as of now I heard that you can still use the POS as 11. it does not have to be POS 02. However if you are giving a just telephone, then the 99441 to 99443 is appropriate.

 

[wisibyusha]

The nurse midwives can bill for telehealth service as long as it is relevant to their practice and consistent with Medicare benefit rules. I am not sure which telehealth e/m code you are using. The 99441 -99443 which is telephone based e/m might require you to append the modifier 95. Also, the POS will be the one you would normally use before the Covid19.
hope that helps.

 

[Mayzoo]

telemedicine , you can code the appropriate E&M code with the modifier of 95. as of now I heard that you can still use the POS as 11. it does not have to be POS 02. However if you are giving a just telephone, then the 99441 to 99443 is appropriate.

Unless video was involved, my understanding is a phone call does not qualify as an E/M.

 

[wisibyusha]

It does as of March 1, 2020. For more information you can check CMS website:
https://www.cms.gov/Medicare/Medicare-General-information/Telehealth/Telehealth-Codes under the sub title: telephone evaluation, management/assessment and management services.

 

[prettytracey3]

It does as of March 1, 2020. For more information you can check CMS website:
https://www.cms.gov/Medicare/Medicare-General-information/Telehealth/Telehealth-Codes under the sub title: telephone evaluation, management/assessment and management services.

For my internal med Clinic and General Practice for Medicare I keep getting denials for my 99441-99443. and I dont know what else to put, they are all telehelth by phone. what else should I be putting?

 

[wisibyusha]

Did you check your documentation? The total time should be documented. Also, you cannot use those codes if the telephone call is originated from the previous office visit of related e/m provided within the previous 7 days or lead to e/m service within the next 24 hours or soonest available appointment. During this pandemic the codes 99441-99443 might require mod. 95.

 

[jlcheritage]

we have been denied for using the 95 on the codes 99441-99443. The description is that of telephone. so the modifier 95 lets the carrier know that it was a telemedicine visit.

 

[lesamarie2006]

We have been told that the 95 modifier is not to go on the codes 99441-99443, but some insurance companies are using POS 11 instead of POS 2

 

[kayleeevans907]

I'm seeing a couple people recommend 99441-99443 for telephone consults. As the original question references a nurse midwife telephone consult codes would be 98966-98968 for a non-physician provider.