Telephone calls: CPT® codes with no reimbursement

March 10th, 2009 - Codapedia Editor
Categories:   Coding   Collections  
0 Votes - Sign in to vote or comment.

Search the Medicare Claims Processing Manual, Chapter 12, for the word "telephone" and the sentences are filled with negatives.  Here's the section from the Manual labeled telephone calls:

B.  Telephone Calls
 
Telephone calls (codes 99371-99373) may not be paid separately.  Payment for telephone
calls is included in payment for billable services (e.g., visit, surgery, diagnostic procedure
results).

99371-99373 are deleted codes, replaced with codes 99441--99443.  Those time-based codes have very specific descriptions which state that the telephone call may not have taken place relating to an E/M service provided in the past 7 days or in the next 24 hours.  Medicare assigns these codes a non-covered status. 

If using these codes for your non-Medicare patients, check with your third party payers to see if they are considered: covered, non-covered, or bundled.  If non-covered or bundled, ask your representative if you are permitted to bill the patient for the service wtih a waiver of liability in place.  Read the full CPT® definition in the CPT® book.

There are instances when phone calls are payable as part of care plan oversight (CPO).  There are two sets of codes to review: Medicare CPO and non-Medicare CPO.  Both require that the patient being cared for is complex, and the covered phone calls are not to the patient.

Physicians and NPPs spend enormous amounts of time performing services which are not currently reimbursed separately from the pre-post work of other services perfomed.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

How to Search Find-A-Code for Medicare Policies and Guidelines — LCDs, NCDs and Articles —
November 18th, 2020 - Raquel Shumway
Help for Searching Find-A-Code when searching for Medicare Policies and Guidelines — LCDs, NCDs and/or Articles.
Cross-A-Code Instructions in Find-A-Code
November 18th, 2020 - Raquel Shumway
Cross-A-Codeis a toll found in Find-A-Code which helps you to locate codes in other code sets that help you when submitting a claim.
COVID Vaccine Codes Announced
November 11th, 2020 - Wyn Staheli, Director of Research
On November 10, 2020, the American Medical Association (AMA) announced the addition of two new codes which will be used for the new COVID-19 vaccines along with 4 new administration codes to be used when reporting the administration of these vaccines.
Are You Aware of the 2021 Star Rating System Updates?
November 5th, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
Each year the Centers for Medicare & Medicaid Services (CMS) publishes the Star Ratings System Updates for Medicare Advantage (Part C) and Medicare Prescription (Part D). This rating system was developed to help beneficiaries identify and select the health plans that best meet their needs, specifically addressing main issues:  Quality of ...
Special Needs Plans Help Beneficiaries and Risk Adjustment Reporting
October 22nd, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
It is no secret that Medicare and Medicaid are steadily moving towards their goal of value-based health care. Medicare Part C (Medicare Advantage) identifies and rewards payers, and subsequently their providers, for increasing the efficiency and quality of care they provide to Medicare...
CMS Expands Telehealth Again
October 20th, 2020 - Wyn Staheli, Director of Research
On October 14, 2020, CMS announced further changes to expand telehealth coverage. Eleven (11) new codes have been added to their list of covered services bringing the current total to 144 services. The new services include some neurostimulator analysis and programming services as well as some cardiac and pulmonary rehabilitation services.
Significant COVID-19 Code Changes as of October 6
October 8th, 2020 - Wyn Staheli, Director of Research
Significan COVID-19 Code Changes as of October 6



Home About Contact Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2020 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association