# CPT for video chat "Consult"



## michelle24 (Sep 5, 2013)

I'm hoping someone can help me with this:

My MD started doing "online visits/consults" with patients overseas. I'm not sure how to go about billing these. 

The medical records & imaging were reviewed in all cases. I let him know to make sure he puts the total time spent in the notes. 

One patient overseas sought him out herself so there is no referring MD as far as a Consult goes. All of the patients are new patients to him so 99441-99444 are out of the question. 

He is the only MD on the video chat so there goes 99366-99368. 

Do you think 99358-99359 would work in this situation?

So confused. Please help with any insight on this. Thanks in advance.


----------



## OCD_coder (Sep 5, 2013)

I am curious as to whether this would even be billable, since this does not meet the requirements of "tele-health" rules.  Second, if the patients are over-seas, what insurance are you trying to bill services too?

The 99344 codes require a provider to be face to face, in person, with the patient.
99358 are Inpatient prolonged service codes.

I am leaning towards this being purely a cash pay at the time of service situation, but I would be very interested and open to any and all other views.


----------



## michelle24 (Sep 6, 2013)

They will most likely all be self pay patients - I know for sure the first one he did was. I still have to code for it though, enter it in our billing system & post the payment. Being that it's not going to Insurance it's not that detrimental but I still have to give the MD some type of answer.  I'm not familiar with telehealth rules at all but just read a bit about it & I'm still unsure of the requirements or what to do in this situation.


----------



## michelle24 (Sep 6, 2013)

I think what I might have him do is use one of the E/M new patient CPT's with the GT modifier & have him add the time to the notes. Like I said it's not going to Insurance but I still want it to be documented correctly.


----------



## OCD_coder (Sep 8, 2013)

There is an unlisted E&M code that would satisfy the CPT code requirements, 99499 which fits your description of what is performed.  

Rationale:
The physician is neither meeting the tele-health requirements and nor the face-to-face requirements of a 99201-99205 codes.


----------



## michelle24 (Sep 9, 2013)

Thanks for your help. I spoke to someone in Compliance at my company & they also said to use the E/M with the GT - face to face was done Ipad to Ipad & he will code by time so he doesn't have to do an Exam.


----------

