Posted
December 10,
2012
Our clinic is having difficulty with the codes we are using for education and injection classes. Typically, we will do the medication outline (letrozole, clomiphene) over the phone with one of our nursing staff members, and the injection class in the office with a nurse.
Currently, we are coding the classes as:
- 98968 - Medication outline
- 98960 – Injection class
Is there a modifier that should be used if these two classes are done in the same visit?
Posted
June 15,
2009
Can you please clarify the intent of the CPT codes for telephone calls? Specifically, I am interested in understanding when it would be appropriate to use the CPT codes 99371, 99372, and 99373. Most reproductive clinicians routinely coordinate medical management or have regular contact with their patients, either directly or indirectly by phone, multiple times during an ART or IUI/FSH cycle. Is it appropriate to bill for these calls in association with rendering daily test results (E2, ultrasounds, etc.), advising patients of daily gonadotropin dosages, answering routine questions and/or discussing future plans? Or, is it not appropriate to bill separately for these items as they are part of routine infertility care?
Posted
June 15,
2009
Does a physician need to speak directly to a patient to code for a telephone consult (99371-99373) or can a physician give specific instructions to a staff member to relay to patients? Patients can be difficult to contact, and physicians have limited time during the day. For example, if a nurse relays information that a pregnancy test is negative and that the patient should start her BCP on Sunday, would this be appropriate to code as 99371?
Posted
June 15,
2009
What is the correct way to bill and receive payment for the patient education sessions performed by registered nurses to individual patients prior to their IVF cycle? We typically spend at least one hour with each patient and partner discussing instructions and protocol for their ovulation induction.
Posted
June 15,
2009
If we have a patient who self-refers to our physician for an initial new patient consultation as opposed to being referred by another physician, how do we code for the consult? Also, when our physician brings the patient back into the office for a follow-up consultation to discuss diagnostic results and treatment recommendations, how do we code? Both of these consultations include approximately one hour of face-to-face time with the physician.
Posted
June 15,
2009
Our reproductive endocrinologist sees patients for recurrent miscarriages. When he sees the patient for the first visit, is it appropriate to use the diagnosis codes V26.4 (procreative management) as a primary code and 629.9 as a secondary code?
Posted
June 15,
2009
What code would be appropriate for an initial visit for infertility? Our practice is in a state where there is no mandated coverage for infertility. We are finding that many insurances will not cover if the word “infertility” is used.
Posted
June 15,
2009
What code is used for a nurse practitioner seeing a fertility patient for the first time?
Posted
June 15,
2009
How soon can you bill as a new infertility patient? If a patient has not been seen since 2004 for infertility and is now returning for infertility in 2006, would they be considered a new patient? What is the time frame to bill again as a new patient?
Posted
June 15,
2009
If an IVF embryo extraction and transfer is performed at an ambulatory surgical center (ASC), can the ASC bill third-party payors a facility fee? Can they bill such a fee in addition to what the IVF physician and the embryology lab may bill?
Posted
June 15,
2009
Can a privately owned office facility dedicated to IVF services and embryology lab bill a facility fee to insurance companies?