Wiki Telephone Services Codes

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dballard2004

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We are having some confusion at my site about how to properly use the CPT codes for telephone services. We are aware of the CPT guidelines about how not to use them, but can anyone please provide me with examples of when they could be used? Thanks.

PS-I am referring to CPT codes 99441-99443.
 
Example: Patient's job demands she/he travels throughout the states. She/he develops an URI while in another state. This patient has been established with her PCP for sometime and he knows /his/her hx. Based on a phone conversation (recording beginning time and ending time) the PCP documents converstation, establishes plan and prescribes medication. This documentation is placed in her medical record and charged accordingly.

Now...this instructor stated that there should be a "profile" developed for those that could benefit from these services'. The patients that meet this profile would agree, ahead of time, to this type of service (when applicable) by signing an agreement (developed by the standards of your practice). As far as pricing, it was suggested that you charge, at minimum, a reasonable copay.
 
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No, Medicare does not cover these services. I have found not too many payors do pay for telephone calls. I did some research and found a couple local payors that do cover them (I'm in Mass). I sent e-mails to my providers reps. The following said no, they aren't covered - Aetna, BCBS of MA, MassHealth, and BMC HealthNet. Health New England and Connecticare I think were the two that said yes they cover them. If I get any more info, I'll post.

:) Erica
 
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