CPT code 98012 refers to a scheduled phone call with a doctor or medical provider to discuss a patient’s ongoing health concerns. CPT 98012 represents “Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 10 minutes must be exceeded.”.
Procedure Explanation:
This procedure involves a phone conversation between a patient and their healthcare provider. The doctor asks important questions about the person’s medical history and/or performs a basic evaluation that does not involve seeing the patient in person. The focus of this call is to make straightforward decisions about the patient’s health care. To bill for this service, the call must last for more than 10 minutes. It does not include video calls or in-person visits.
Common Names:
- Audio Visit
- Phone Consultation
- Telehealth Call
Relative Value Units (RVU):
The RVUs associated with this code are 0.65.
How This Procedure Appears:
- Operating Room Schedule Name: Not applicable, as this is a telephone service, not a procedure requiring an operating room.
- Surgical Consent Form Name: Patient verbal consent for phone consultation
Typical Patients and Diagnoses:
This type of appointment is especially useful for patients who have ongoing conditions and need regular check-ins with their doctor. For example, a person with high blood pressure or diabetes may use this service to discuss their condition and manage their medication. It’s also suited for patients who may have mobility limitations or are unable to travel to a clinic.
Associated ICD-10 Codes:
- I10: This code represents hypertension, a common condition where blood pressure in the arteries is persistently elevated.
- E11.9: This code is for type 2 diabetes without any complications, which indicates a patient’s blood sugar levels are too high.
- J00: This code signifies acute nasopharyngitis, more commonly known as a common cold.
Summary
In summary, code 98012 describes a phone call between a healthcare provider and their patient, with a focus on straightforward medical decision-making. Typical ICD-10 codes associated with 98012 include I10 (hypertension) and E11.9 (type 2 diabetes without complications).
Disclaimer
This post is for informational purposes only and is not a substitute for medical advice. “CPT” and CPT Codes are registered trademarks of the American Medical Association. HCPCS codes are managed by Medicare and are not subject to copyright.