Urology Coding Alert

Question: I haven’t had to report any of the new telemedicine codes for 2019 yet. What should I know about potential reimbursement issues and obtaining patient consent?

Indiana Subscriber

Answer: Medicare pays for many telemedicine services, and most commercial insurers also do. In fact, many states have regulations that require all payers to reimburse for telemedicine. You should not have any issues with payers as long as you follow all the rules and bill correctly.

The potential for telemedicine services originates when the patient presents at your office or other facility. Their asking for services and/or treatment implies consent for whatever care your physician offers. Remember, however, that the patient cannot be in his or her home or place of business for telemedicine services to apply.

Note: Review Appendix P in the 2019 CPT^® manual for CPT^® codes that may be used for synchronous (real time) telemedicine services. The codes listed are identified in the 2019 CPT^® manual with a star symbol. When billing via telemedicine, append modifier 95 (Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system) to the procedure code (for example, 99203-95).