Wiki Derm TeleMed - Need immediate Help

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Sarahp941

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Bradenton, FL
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Does anybody have experience or are going to start TeleMed for Dermatology? I work for a large Dermatology office in Florida and need some immediate assistance as we have a big meeting about TeleMed coming this week. We will be using the online platform Zoom for our interactive audio and video telecommunication system . This will be for our biologic patients and other dx such as rash, dermatitis, etc. I have read CMS guidelines but I am still getting mixed information for coding. Do you use the 99211-99215 with GT mod, "02" POS? Or do you use the new codes: 99441-99443; 99421-99423 with 95 mod? I'm also not sure about the documentation. Do you follow the same 3 key components or is it documented differently because it will be online based? I'm not sure if I just confusing myself but any help is greatly appreciated. Thanks!
 
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For Medicare you do not use the GT modifier anymore except for very special location.. you should look it up to see if you qualify . You use only the 02 POS commercial uses the 95 modifier.
If it is audio and visual then you may bill as telehealth using regular OV codes
If it is telephone only use 99441-99443 with no modifier and time must be documented following the rules in the book
If it is via your office secure e-portal use 99421-99423 with no modifer
 
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Hi Sarah, I also work in a dermatology practice and have the exact same questions. I tried calling several of the individual payers (Anthem, UHC, etc) to see if they have a policy they can direct me to or if they can tell me how they prefer it be billed, but non of them seemed to know what I was talking about. I hope someone out there will have an answer!
 
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The 99441-99443 codes are for phone calls that must be patient initiated please look in your code book for the rules
The 99421-99423 code replace the deleted 99444 code and are for patient initiated online visits again there is an entire section of information on these in the CPT book
These are NOT telemedicine and need no modifier and have no restrictions as to where the patient must be at the time of the service
TELEHEALTH is different it is a service created to provide access to the more rural patient and has restrictions also the patient cannot be in their home, they must be a defined originating site at the time of service.. so far I have not read anything that overrides this. We no longer use the GT modifier for Medicare unless you are located in certain special places such as Alaska. You do use the 02 POS. The Medicare online manual has a tone of information regarding telehealth
 
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Hi I'm in a dermatology office that is immediately looking to start telemedicine to accommodate the cancelled appts that are due to the covid-19 pandemic. We are potentially going to close the practice and just have our providers doing the telemed. I would love some insight on how I will need to be coding and documenting these visits.

Thanks!!
 
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On the telephone codes, how long after patient initiates request does our physician have to respond. I have a patient that sent a web inquiry on 3/17/20 asking how we would handle patients with compromised immune systems. The M.A. called her and scheduled her for a phone appt on 3/24/20. I don't think this is how it works, the guidelines in CPT 2019 ( I don't have CPT 2020 right now) do not guide us in a timely response, but to be scheduled for a telephone appt a week later does not seem right to me. If anyone can help, I appreciate it. Thank you
 
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That does not sound like a phone call to me. I was always told if the provider cannot come to the phone the the call must be returned that same day. For HIPAA compliance the patient opened the portal and the portal can be considered open until the end of the business day. The difference between phone call and telehealth is the telehealth is both audio and visual and phone is only audio so there is no real confirmation to whom you are speaking. Have them schedule it as an audio and visual visit and call it telehealth.. the president just lifted the originating site restrictions for telehealth. Bill as an ov with 02 POS no modifier for Medicare
 
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mitchellde said:
That does not sound like a phone call to me. I was always told if the provider cannot come to the phone the the call must be returned that same day. For HIPAA compliance the patient opened the portal and the portal can be considered open until the end of the business day. The difference between phone call and telehealth is the telehealth is both audio and visual and phone is only audio so there is no real confirmation to whom you are speaking. Have them schedule it as an audio and visual visit and call it telehealth.. the president just lifted the originating site restrictions for telehealth. Bill as an ov with 02 POS no modifier for Medicare
Click to expand...
Phone call by patient to provider she spoke to them on their acne and they are on Accutane she asked all questions she would have I office and documented it how do I bill this?
 
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No no modifier for phone calls.. it be aware these are not telehealth visit and still may not be paid.. from what I am reading the online e-visits maybe paid billed with 99421-99423 and they have lifted the originating site restriction today for telehealth which must audio and visual.
 
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for the telemed visits one of the providers gave us this info does this sounds correct as we venture into for us what is uncharted territory I just need a little help thanks

Bill your visit as you would any other office visit. But you must modify the E/M with -GT for Medicare or -95 for commercial. These modifiers should be at the top of the list in the selection box.
 
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Dr did an video visit with a patient because of the covid-19 office closure and exposure this was done Now do I bill 99213 and POS 2 and a special mod or do I need to bill one of these new 99421-99423 codes and if so does it need special modifier or no? I thought I read something about with all that's going on they were to bill as normal with POS as 2 . Can someone please help and clarify
 
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mitchellde said:
For Medicare you do not use the GT modifier anymore except for very special location.. you should look it up to see if you qualify . You use only the 02 POS commercial uses the 95 modifier.
If it is audio and visual then you may bill as telehealth using regular OV codes
If it is telephone only use 99441-99443 with no modifier and time must be documented following the rules in the book
If it is via your office secure e-portal use 99421-99423 with no modifer
Click to expand...
it a commercial plan and its audio and visual so use the 95 modifier? am I understanding that? Thanks again for your insight
 
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