Coding Nerve Block Follow Up | Medical Coding Training

Coding Nerve Block Follow Up | Medical Coding Training


Laureen: Nerve Block Follow Up Q: When coding continuous nerve blocks 64415,
64446 or 64448 how do you code for the follow up when the patient is sent home with the
catheter and the follow up is being done via telephone by the anesthesiologist? A: It’s my understanding that you can’t directly
bill for a phone follow up; but, if you document the call and you review those notes at the
next face-to-face visit, then you can count it toward “data reviewed” as part of the medical
decision making. So, you can’t really get paid for it, but you can if they’re going
to come back. There are CPT codes for telephone calls; and
a lot of physicians when they see that, they’re like, “I knew I could get paid for telephone
calls!” But, we have to remember that just because a code exists in CPT does that mean
it’s billable. CPT was originally designed just to track everything that a physician
did, not necessarily for billing. It eventually became used for that. The guidelines also say “if the telephone
call refers to an E/M service performed and reported by the physician within the previous
seven days (either physician requested or unsolicited patient follow-up) or within the
postoperative period of the previously completed procedure, then the service(s) are considered
part of that previous E/M service or procedure.” Basically, it’s kind of like a global package
so that phone call to the payers they consider bundled into the service that was already
billed. And that’s pretty much what I’ve found that most insurance companies will not pay
for these phone calls even if it’s outside of the seven days. It’s just really considered
standard of care and most people do not charge for it separately.

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