Pulmonology Coding Alert

Question: Which E/M codes should I use if I see a patient for an e-visit? We have been doing these for our patients to check in following thoracotomy to make sure they are feeling well.

Arkansas Subscriber

Answer: E-visits typically take place through a secure online portal, allowing you to virtually meet with the patient digitally. If the visit is related to a procedure and the e-visit takes place during that surgery’s global period, then you won’t report any code at all. Instead, the e-visit would be included in the surgical package.

If, however, you’re performing an e-visit that isn’t related to a surgery with a current global period in place, then you can report any of these time-based E/M codes:

• 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 (…11-20 minutes)
• 99423 (… 21 or more minutes)

Make sure physician documentation includes patient consent, patient location, chief complaint/reason for encounter, justification for telehealth services, pertinent history, exam, medical decision making, diagnosis, and duration of encounter.