Outpatient Facility Coding Alert - 2024 Issue 6
Reader Questions: Phone in This E/M Encounter
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Article Overview
This reader Q&A discusses a common billing scenario involving an office-based encounter with COVID-19-related precautions and a provider-patient interaction completed without video. It is relevant to coders, billers, and compliance staff working with office/outpatient E/M services and telephone-based E/M reporting, especially where telemedicine and payer-specific guidance may affect claim selection.
Why This Topic Matters
The article helps readers recognize the general distinctions between office/outpatient E/M services, telemedicine-related reporting, and telephone-based E/M services in a real-world workflow scenario. It is useful for avoiding misclassification of encounters and for understanding when payer guidance may need to be checked.
What You Will Learn
- The general categories of E/M services discussed in the scenario
- How audio-only encounters are distinguished from visits involving interactive audio-video technology
- Why payer-specific guidance may matter in unusual office-based remote encounter situations
- What types of coding topics arise when a patient is seen in the office but the provider does not examine the patient face to face
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Practice managers
- Telehealth billing teams
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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