decisionhealth Newsletters, Coder Pink Sheets - 2023 Issue 6 (June)
Q&A: Here’s why calling patient with test results is not a telephone E/M service
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Article Overview
This Q&A reviews telephone E/M billing guidance for practices that call patients with test results and want to know whether those calls can be reported as billable services. It summarizes the CPT framework for telephone E/M, discusses common situations that affect whether a call is separately reportable or bundled, and highlights documentation and compliance considerations for physicians, nurse practitioners, and coders.
Why This Topic Matters
It helps practices avoid misbilling routine result notifications as telephone E/M services and understand the broader compliance implications of telephone-based patient communication.
What You Will Learn
- How telephone E/M services are generally framed in CPT guidance
- Why calls about test results may not qualify as separately reportable telephone E/M services
- What general circumstances can affect whether a telephone call is bundled with other care
- What documentation elements are discussed for support of a billable telephone encounter
Who Should Read This
- Physicians
- Nurse practitioners
- Coders
- Billing staff
- Compliance staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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