Family Practice Medical Coding – Some Significant Updates

Family physicians   bill for injections using an  code (if it is a drug/biological) or a   code (if it is a vaccine). The hydration and injection codes have been changed to make them numerically closer to the codes signifying chemotherapy and highly complex drug or biological agents. The code 90772 has been deleted and now physicians have to bear in mind the code 96372 which is to be used to report “Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular.” The 96360-96379 code series now also includes codes for other hydration,  , and  drug injection and infusion procedures.

for Tobacco, Alcohol and Substance Abuse

A  visit for tobacco cessation lasting longer than 3 minutes and up to 10 minutes is to be reported using Code 99406. Rigorous    that takes more than 10 minutes can be reported with Code 99407.

The new codes 99408 and 99409, the former for services lasting for 15 to 30 minutes and the latter for services lasting longer than 30 minutes, should be used to report structured screenings and brief interventions for alcohol and substance abuse (other than tobacco). In this case, screening tools such as the AUDIT (Alcohol Use Disorders Identification Test) or the   (Drug Abuse Screening Test) have to be used.
Family Practice Coding for Telephone and Online Services

Telephone Services
Family Practice physicians can now code for service and care initiated by an established patient or by the patient’s guardian. These are:

99441 – telephone evaluation and management service provided to an established patient, parent or guardian not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours; 5-10 minutes of medical discussion
99442 – just as 99441, except call includes 11-20 minutes of medical discussion
99443 – just as 99441 except call includes 21-30 minutes of medical discussion
Aspects to Take Note of While Billing for Telephone Services

Online Services

The physician has to provide the service personally. o A service provided within the post-operative period that the physician has provided is not to be separately reported since it would be considered as part of the procedure. o When the telephone services are already  99363-99364, they cannot be separately reported. o Whether physician requested or patient initiated, telephone services that refer to E/M services performed and reported by the physician within the previous seven days, cannot be separately reported.

has been deleted and replaced by code 99444 to report online medical evaluations.

is the code to be used for an online E/M service provided by a physician to an established patient, guardian or healthcare provider. The service should not be one related to an E/M service provided within the previous seven days, via the Internet or similar electronic communications network.

The services reported must be the physician’s own, timely response to the patient’s inquiry.

An online service related to and taking place within the postoperative period of a procedure provided by the physician, is considered part of the procedure and cannot be separately

If the online service refers  to an E/M service performed and reported by the physician within the previous seven days, it is not to be separately reported, whether it is the result of patient-initiated or physician-requested follow-up.

The service can be reported only once for the same episode of care in a seven-day period and covers all other communications originating from the online encounter (whether follow-up telephone calls, prescription provision, and lab and imaging orders).

The physician should have the electronic or hard-copy documentation of the encounter for reference.


Leave a Reply

Your email address will not be published. Required fields are marked *