Betsy Nicoletti, MS, a coding specialist nationally recognized, will lead your encoding questions by email and provide guidance on how to properly encode to maximize repayment. Do you have a question about coding? Send it here.
In this column, Nicoletti discusses a recent government decision to align rates for telephone-based visits with face-to-face office visits.
. Be paid for patient visits by phone
. q : the centers for the medicare
Crack Fat Loss Code - Telephone vs Telemedicine: Code and Bill Correctly During COVID-19
. 99442 : 11-20 minutes of medical discussion
. 99443 : 21-30 minutes of medical discussion
Although current procedural terminology (CPT) describes these as services for established patients, CMS is renouncing this requirement and allowing these codes to be used for new and established patients.
These services need not be initiated by the patient. The patient's initiation requirement is for Digital Digital Message Codes 99421-99423 and G2010 and G2012 virtual communications codes, but this is not the case with audio telephone visits only.
CMS has not renounced other code descriptors, which the call can not be a result of an I / M service in the last 7 days or result in an e /m service in the next 24 hours or faster the available query.
.. Refund for phone calls
CMS increased the payment of retroactive phone calls on 1 March and is paying the codes fee 99212-99214:
Wrvu
National payment of nonfacility
National installation payment
99212 99441
0.48
46.13
26.31
99213 99442
0.97
76.04
52.26
99214 99443
1,50
110.28
80.37
The times are similar as well. Practices can select the telephone code based on total time spent on the phone by the practitioner with the patient.
99441: 5-10 minutes 99212: 10 minutes 99442: 11-20 minutes 99213: 15 minutes 99443: 21-30 minutes 99214: 25 minutes
For Medicare, do not use the service location 02 (Telehealth) for codes in the TeleHealth list. Use the place of service where the service would have been provided if made face to face. For phone calls, this is more likely to be the office or outpatient department. Add the modifier -95 to the codes for Medicare services, however.besides that add these codes to the List of Telehealth launched at the end of April, CMS added a column to the list that has shown that services can only be supplied with audio equipment .
.I also received questions via e-mail in the following aspects of teleúde and Covid-19, so here are some answers to help yours who asked.
. Office visits via telemedicine
Billing for office visiting codes 99201-99215, made via telemedicine, interactive equipment and visual equipment is still required. During public health emergency time, CMS is allowing professionals to select the service level for these office visits based on total time or medical decision-making.
CMS clarified in its April rule that professionals should use CPT times. Counseling does not need to dominate the visit in order to use time.
. Other communications-based technology services
Digital digital E / M services 99421-99423 and Virtual communication codes G2010 and G2012 are not considered telesudia. These codes have been developed for use by doctors, medical assistants and advanced nursing professionals performing and / m services online by means of a secure platform.
CMS defines them as communications-based technology services. Because they are not on the list of telehealth disclosed by Medicare at the end of April, do not use POS 02 or modifier 95 in these codes, as they are not telehealth codes.
. Cost Sharing and CS Modifier
It is a federal law that health insurers cover tests for Covid-19 and the visit in which the test is ordered without evaluating the patient's value.
Append CS modifier for the test and for the visit to be paid. This can apply to retroactive services on March 18. There are limited circumstances in which there are no cost sharing and there will be patients and values for treatment for Covid-19.
All these amendments are in force during the emergence of public health.. Do you have a coding question? Send it in and can be answered in a future column. (Please make sure to observe your specialty in the question text.)
. Betsy Nicoletti, MS, is a consultant, author and speaker, as well as the founder of Codingintel.com, a library of medical practice coding resources.
