General practice 14079 - Gp telephone/email management fee

General Info

Billing Amount: $15.00

This Item requires times

Description

This fee is payable for two-way communication with eligible patients, or the patient’s medical representative, via telephone or email by the GP who has billed and been paid for at least one of the following GPSC incentives: Complex Care Planning Fee (G14033) Mental Health Planning Fee (G14043) Annual Chronic Care Bonus for COPD (G14053) Palliative Care Planning Fee (G14063) Attachment Complex Care Management Fee (G14075) This fee is billable for medical management of the conditions covered under the initial planning/Chronic Care fee. This fee is not to be billed for simple appointment reminders or referral notification.

Notes:

The following list of diagnosis and acceptable (ICD9) codes are applicable for the Mental Health Planning and Management Fee, fee items G14043, G14044 – G14048, and G14079:
Adjustment Disorders: (309)
Adjustment Disorder with Anxiety (309)
Adjustment Disorder with Depressed Mood (309)
Adjustment Disorder with Disturbance of Conduct (309)
Adjustment Disorder with Mixed Anxiety and Depressed Mood (309)
Adjustment Disorder with Mixed Disturbance of Conduct & Mood (309) Adjustment Disorder NOS (309)Anxiety Disorders: (300)
Acute Stress Disorder (308)
Agoraphobia (300)
Anxiety Disorder Due to a Medical Condition (300)
Anxiety Disorder NOS (300)
Generalized Anxiety disorder (50B), (300)
Obsessive-Compulsive Disorder (300)
Panic Attack (300)
Post-Traumatic Stress Disorder 309
Social Phobia (300)
Specific Phobia (300)
Substance-Induced Anxiety disorder (300)
Attention Deficit Disorders:
Attention Deficit disorder (314)
Cognitive Disorders: Amnestic Disorder (294)
Delirium (293)
Dementia (290),(331),(331.0),(331.2)
Dissociative Disorders:
Depersonalization Disorder (300)
Dissociative Amnesia (300)
Dissociative Fugue (300)
Dissociative Identity Disorder (300)
Dissociative Disorder NOS (300)
Eating Disorders:
Anorexia Nervosa (307.1), (783.0), (307)
Bulimia (307)
Eating Disorder NOS (307)
Factitious Disorders: (300),(312)
Factitious Disorder; Physical & Psych Symptoms (300),(312)
Factitious Disorder; Predom Physical Symptoms (300),(312)
Factitious Disorder; Predominantly Psych Symptoms (300),(312)
Impulse Control Disorders: (312)
Impulse Control Disorder NOS (312)
Intermittent Explosive Disorder (312)
Schizophrenia and other Psychotic Disorders: (295),(296),(297),(298)
Paranoid Type (295),(297),(298)
Disorganized Type (295), (298)
Catatonic Type (295), (298)
Undifferentiated Type (295), (298)
Residual Type (295), (298)
Brief Psychotic Disorder (295), (298)
Delusional Disorder (295), (298)
Psychotic Disorder due to Medical Condition 293
Psychotic Disorder NOS (295), (298)
Schizoaffective Disorder (295), (298)
Schizophreniform Disorder (295), (298)
Substance-Induced Psychosis (295), (298)
Sexual and Gender Identity Disorder Paraphilias: (302)
Exhibitionism (302)
Fetishism (302)
Frotteurism (302)
Pedophlia (302)
Sexual Masochism (302)
Sexual Sadism (302)
Transvestic Fetishism (302)
Voyeurism (302)
Paraphilia NOS (302)
Sexual Dysfunction: (302)
Hypoactive Sexual Desire Disorder (302)
Female Orgasmic Disorder (302)
Male Orgasmic Disorder (302)
Premature Ejacualation (302)
Sexual Aversion Disorder (302)
Sexual Dysfunction due to a Medical Disorder (625)
Sexual Dysfunction due to a Substance (302)
Sexual Pain Disorders:
Dyspareunia (not due to a Medical Condition) (302)
Vaginismus (not due to a Medical Condition) (302)
Sleep Disorders:
Primary Insomnia (307)
Primary Hypersomnia (307)
Narcolepsy (347)
Breathing-Related Sleep Disorder (780.5)
Circadian Rhythm Sleep Disorder (307.4)
Insomnia Related to Another Mental Disorder (307.4)
Nightmare Disorder (Dream Anxiety Disorder) (307.4)
Sleep Disorder Due to a Medical Condition (780.5)
Sleep Disorder Related to another Medical Condition (780.5)
Sleepwalking Disorder (780.5)
Substance-Induced Sleep Disorder (780.5)
Somatoform Disorders: Somatization Disorder ( 300.8)
Conversion Disorder ( 300.1)
Pain Disorder ( 307.8)
Hypochondriasis ( 300.7)
Body Dysmorphic Disorder ( 300.7)
Substance - Related Disorders: Substance-Induced Anxiety Disorder (303), (304), (305)
Substance-Induced Mood Disorder (303), (304), (305)
Substance-Induced Psychosis (292)
Substance-Induced Sleep Disorder (303), (304), (305)
Alcohol Dependence Syndrome (303)
Drug Dependence Syndrome (304)
Drug Abuse, Non-Dependent (305)

Payable to a maximum of 5 times per patient per calendar year following the successful billing of G14033, G14043, G14053, G14063 or G14075 within the previous 18 months.

Telephone/Email Management requires two-way communication between the patient or the patient’s medical representative and physician or medical office staff for the purpose of medical management of the relevant chronic condition(s); it is not payable for simple notification of office or laboratory appointments or of referrals.

iii) Payable only to the physician paid for the G14033, G14043, G14053, G14063 or G14075 unless that physician has agreed to share care with another delegated physician. To facilitate payment, a note record should be submitted by the delegated physician.
iv) G14016, Community Patient Conferencing Fee, payable on same day for same patient if all criteria met. Time spent on telephone with patient under this fee does not count toward the time requirement for the G14016.
v) G14077 GP Attachment Patient Conference Fee payable on same day for same patient if all criteria met. Time spent on telephone with patient under this fee does not count towards the time requirement for the G14077.
vi) Not payable on the same calendar day as a visit or service fee by same physician for same patient with the exception of G14016.
vii) Not payable on same day for same patient as G14076 GP Attachment Patient Telephone Management Fee.
Chart entry must record the name of the person who communicated with the patient or patient’s medical representative, as well as capture the elements of care discussed.
Successful billing of the mental health planning fee (G14043) allows access to 5 Telephone/e-mail follow-up fees (G14079) per calendar year.over the following 18 months.