A patient calls his primary nurse practitioner because he is having abdominal pain and diarrhea. He speaks with his her for five minutes and after obtaining more signs and symptoms, the nurse practitioner suspects the patient is suffering from a gastrointestinal virus. The patient is recommended to proceed with supportive care, and if not improving in 48-72 hours, to follow up in the physician's office. The patient improved, so did not have to follow up in the office. What is the correct CPT code for this type of telephone service?

Question

Quizplus · Accepted Answer

98966 is the correct code for a 5-10 minute telephone contact for a nonphysician healthcare professional. If the patient would have followed up within 24 hours or at the soonest available appointment, then this code would not be able to be used because this telephone service would be considered part of the patient's workup for that office visit.
Codes 98967 and 98968 are codes for 11+ minutes of telephone consultation services. Code 98969 is incorrect because this code is for online assessment and management services, not telephone services.

A Patient Calls His Primary Nurse Practitioner Because He Is