Curago Health Blog

Coronavirus Telehealth Codes. Get 'em while they last!

Mar 18, 2020 10:15:00 AM / by James Deck

The following is from the folks over at NewportMed.com:

Coronavirus Telehealth/Telephone CPT Guidelines

This service is non-face to face; both MD's and mid-levels are eligible to bill for this service. This code series is also time-based and specific documentation requirements must be met.

99421

Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes.

 

99422

Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes.

 

99423

Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes.

 

99421, 99422, and 9923 can only be billed once per 7 days. You will see in the code description states that the time is cumulative - your provider can sum up the time spent with the patient and bill accordingly. Note, the provider cannot include time spent with other services with these codes.

Services cannot be billed on the same day as an office visit or consult. This service is not billable if the patient was treated within 7 days of the E/M for the same symptom.

Per CPT Guidelines:

● These services are not for the nonevaluative electronic communication of test results, scheduling of appointments, or other communication that does not include E/M.

● The patient is an established patient. New symptoms may be evaluated.

● The seven-day period begins with the physician's or other QHP's initial, personal review of the patient-generated inquiry. Physician's or other QHP's cumulative service time includes review of the initial inquiry, review of patient records or data pertinent to assessment of the patient's problem, personal physician or other QHP interaction with clinical staff focused on the patient's problem, development of management plans, including physician- or other QHP generation of prescriptions or ordering of tests, and subsequent communication with the patient through online, telephone, email, or other digitally supported communication, which does not otherwise represent a separately reported E/M service. All professional decision making, assessment, and subsequent management by physicians or other QHPs in the same group practice contribute to the cumulative service time of the patient's online digital E/M service. If the provider schedules a visit within the 7 day period of initiating the telehealth service, then the time spent can be used to determine the E/M level.

Last Revised: March 12, 2020, 3:00 pm CST

Telephone Services

( Physicians) Telephone services are non-face-to-face evaluation and management (E/M) services provided to a patient using the telephone by a physician or other qualified health care professional, who may report evaluation and management services. These codes are used to report episodes of patient care initiated by an established patient or guardian of an established patient.

99441

Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5- 10 minutes of medical discussion

99442

Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion

 

99443

Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion

Telephone services are non-face-to-face evaluation and management (E/M) services provided to a patient using the telephone by a physician or other qualified health care professional, who may report evaluation and management services. These codes are used to report episodes of patient care initiated by an established patient or guardian of an established patient. If the telephone service ends with a decision to see the patient within 24 hours or next available urgent visit appointment, the code is not reported; rather the encounter is considered part of the preservice work of the subsequent E/M service, procedure, and visit. Likewise, if the telephone call refers to an E/M service performed and reported by that individual within the previous seven days (either requested or unsolicited patient follow-up) or within the postoperative period of the previously completed procedure, then the service(s) is considered part of that previous E/M service or procedure.

Last Revised: March 12, 2020, 3:00 pm CST

Assign HCPC’s

 

G2012

Brief communication technology-based service, e.g. virtual check-in, by a

physician or other qualified health care professional who can report evaluation and management services,

provided to an established patient, not originating from a related e/m service provided within the previous 7

days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment;

5-10 minutes of medical discussion , for your Medicare patient’s.

Place of Service

● Per CMS, “ Submit telehealth services claims, using Place of Service ( POS ) 02- Telehealth , to

indicate you furnished the billed service as a professional telehealth service from a distant site.”

Last Revised: March 12, 2020, 3:00 pm CST

Tags: revenuecycle, billing, Telehealth

James Deck

Written by James Deck

James Deck has been an innovator in the healthcare industry for nearly two decades specializing in patient engagement, AI, Pop Health, Value Based Care, cloud and managed IT services.