Coding Corner: Interprofessional Telephone/Internet/Electronic Health Record Assessment & Management

Example 1

A cardiologist contacts a rheumatologist concerning a lupus patient. The rheumatologist sees the patient four weeks later for a complete examination. A 20-minute call is initiated to review the findings and the patient’s chart with the cardiologist. After the call is completed, the rheumatologist completes a verbal and written report to the patient’s treating/requesting provider and places the written report in the patient’s records.

How to Code

CPT code 99447, ICD-10 M32.9

Rationale: This visit meets the requirement for the 99447 interprofessional telephone assessment and management service because there was a patient visit and the rheumatologist spoke with the treating/requesting physician for 20 minutes. Verbal and written reports to the treating/requesting provider are required, as well as documentation in the patient’s chart.

An important note: This was a new patient, and the rheumatologist had not seen or planned to see the patient within 14 days of the consultation visit.

Example 2

A primary care physician (PCP) speaks to the rheumatologist for 10–15 minutes concerning an established patient’s exacerbated rheumatoid arthritis status. They discuss the patient’s symptoms and why the PCP feels changes to the patient’s prescription management are necessary. After the call is completed, the rheumatologist completes a written report of what was discussed and places it in the patient’s medical charts. A visit is scheduled with the patient to see the rheumatologist within the next 5–10 days.

How to Code

CPT code 99446, ICD-10 M06.09: UNBILLABLE

Rationale:  CPT code 99446 is unbillable for this service. Although the rheumatologist spoke with the PCP for 10–15 minutes and verbal and written reports were placed in the patient’s chart, a visit was scheduled in 5–10 days. Per CPT guidelines, the 99446 interprofessional telephone or internet assessment and management service code cannot be billed if there is a plan to see, or has seen, the patient within 14 days.

Editor’s note: Case vignettes presented in the Coding Corner are created to illustrate questions about coding. They are not intended to represent the full medical record of a case.