99441- 99443: The Harsh Reality about Telephone Calling Codes

In a certain situation, another physician told my surgeon that he is receiving payment for his contractor for telephone calling codes. My surgeon would like to begin using these codes as well. So does Medicare pay for telephone calls?

Medicare takes telephone call codes 99441- 99443 (Telephone E/M service provided by a physician to an established patient, parent, or guardian not originating from a related Evaluation/Management service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; …) to be non-covered services.

Here's how: You can find a code's status in column D of the 2010 Medicare Physician Fee Schedule.

Silver lining: Technically, your physician is getting paid for telephone calls made in relation to performed office visits. “The physician work resulting from telephone calls is considered an integral part of the pre-work and post-work of other physician services, and the fee schedule amount for the latter services already includes payment for the telephone calls.

The relative value units (RVU) for office visits include time for work that's spent prior to and after the visit on items like pulling the chart, reviewing lab results, and calling the patient. As the fee schedule includes RVU for 99441- 99443, some private and other public payers may pay for the codes, however remember that the guidelines are very specific for reporting these codes. The patient must be established to the practice, must have initiated the call to the physician and the information discussed cannot be directly related to a visit seven or less days prior to the phone call. What's more, the call cannot take place when the patient makes an appointment to see the doctor regarding the health issue within a day.

For further updates on telephone calling coding and Medicare Physician Fee Schedule updates, sign up for a medical coding guide like Supercoder.