Medical Coding

Category - Evaluation and Management

The nurse practitioner returned a phone call from a concerned daughter regarding her ailing mother’s health. She spent 20 minutes counseling the daughter on how to provide hospice care during the last stages of her mother’s life. It had been three weeks since the patient had been seen in the office, and her next scheduled appointment was in two weeks. What E&M service can be reported for this phone call?
  1. You cannot report an E&M service for this phone call
  2. 99442
  3. 98967
  4. 99443
Explanation
Answer: B - The E&M service that can be reported for this phone call is 99442 (Telephone E&M Service Provided by a Qualified Non-Physician Health Care Professional; 11-20 Minutes of Medical Discussion). The phone call did not originate from a previous visit (within the last 7 days) and it also did not occur in response to an upcoming doctor’s visit (within the next 24 hours), therefore you can code for this service. In addition, code 99442 is more appropriate than 98967 because a nurse practitioner qualifies as a non-physician health care professional.
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