Legal Tips
Provided by Carolyn Buppert, MSN, JD, ANP

Q: Can I code, and be reimbursed for telephone calls with patients?

A: You can code telephone calls (CPT codes 99371-99373) but most fee-for-service third-party payers will not pay a bill for these codes. Under fee-for-service reimbursement, a face-to-face visit is necessary. However, if the patient is covered by a capitated rate; i.e. the practice receives a set fee per month for the care of the patient, then telephone calls are being reimbursed under that fee. In a capitated payment system, telephone calls are more cost-efficient to a practice than an office visit.

Q: Can I cover the time spent on my telephone calls by upcoding the next office visit with that patient, based on what I did in the telephone call?

A: No, not legally.

This tip is excerpted from The Green Sheet, a newsletter on compensation and reimbursement for nurse practitioners, published monthly by the Law Office of Carolyn Buppert.

Subscriptions: $25 per year (12 issues), mailed first class. To receive The Green Sheet every month, mail your name, address and a check for $25 to Law Offices of Carolyn Buppert, 1419 Forest Drive, Suite 205, Annapolis, MD 21403.

A companion newsletter, The Gold Sheet, addresses malpractice avoidance and quality for NPs. The Gold Sheet is also $25 per year.

Next month: "How to bill for hospital services," covered in the March Green Sheet.

Updated March 5, 1999


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