Medical Coding

Category - Evaluation and Management

A patient’s mother calls, asking to speak with the physician, because her three year old is having behavioral problems at school and at home, including biting and sudden bedwetting. It was recommended that she set up an appointment, but the mother reports that, due to work schedule, she won’t be able to get her son in until next week, but will set up an appointment to follow up in the office. The physician spends 15 minutes on the phone with her discussing the behavior, and that this may be related to life changes because there have been some changes going on with the patient’s dad no longer living in the home. He recommends following up tomorrow due to the increased bedwetting, but due to the mother’s schedule, she is unable to do this. What is the correct evaluation and management code for this patient encounter?
  1. 99441
  2. 99442
  3. 99443
  4. 99444
Explanation
Answer :B - 99442 is the correct code for 11-20 minutes of telephone services that are well documented in the chart and that do not result in an E/M service within the next 24 hours or soonest appointment and that does not relate to a previous E/M service within one week prior to the telephone call.
Code 99441 is incorrect because this code is for telephone calls that last 5-10 minutes. Code 99443 is incorrect because this code is for telephone services between 21-30 minutes. Code 99444 is incorrect because this code is for online medical evaluation instead of telephone services.
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