AUC Medical Code TAG Meeting Materials 03-14-13 - Minnesota ...

DRAFT
AUC BUSINESS NEED EXPLANATION
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BACKGROUND
SITUATION – Describe the current business practice(Please describe the problem or issue to be
addressed):
In 2013, the AMA revised CPT codes 99441-99443 for telephone
E/M services, 99444 Online E/M service, 98966-98968 for
telephone assessment and 98969 for online assessment. The
revised language now states that codes 99441-99443 and 99444
should be used by a "qualified health care professional who may
report evaluation and management services". A nurse
practitioner (NP), physician assistant (PA) or a clinical nurse
specialist (CNS) would meet this definition. However, in the
837P Minnesota Uniform Companion Guide, providers are instructed
to use 99441-99443 and 99444 for MD/DO/DC only. NP, PA and CNS
providers are instructed in the guide to use the codes in the
Medicine section of the CPT manual (98966-98968 and 98969).
– Explain the pertinent history of the business practice (How does this work today):
NP, PA and CNS providers are currently instructed to report
telephone and online visits with codes 98966-98968 and 98969.
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ASSESSMENT
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RECOMMENDATION
– Summarize your analysis of this issue (what are your challenges, what type of
organizations are impacted by these challenges – provider types, health plans, others? Please indicate
how this applies to AUC‘s mission, vision, values, and strategy. Are there any national or community
standards that exist or are being developed that might help address the situation? If so, please explain):
The language in the Companion Guide directly contradicts the
language in the CPT manual.
– What are you recommending including any known timing that needs to be
considered:
This affects dates of service beginning 1/1/2013. I
recommend that the language be changed in the companion guide or
the language is removed altogether from the guide.
CONTACT INFORMATION –
This form was completed by:
Name: JoAnne Wolf, RHIT, CPC, CEMC
Title: Coding Manager
Email address: joanne.wolf@childrensmn.org
Phone number: 612-813-5972
Organization: Children's Physician Network
Address: 910 E. 26th St., Suite 330, Minneapolis, MN 55404
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