Wiki Home Visit with Video

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dcrmcroberts

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A Patent is visited by a nurse at home while a physician is online video with the both of them. What I have found is that this would be coded with the 99201-99215 with modifier -GT (Video). However, the Place of service for the E/M codes does not accept -12 (Home), but there is a POS -99 that says, Under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. In such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service. Any thought on the coding of this situation would be welcome! Thank you in advance.
 
Telehealth billing have very specific requirements, your scenario does not appear to meet those requirements to support a GT or a 99 modifier based on the information you have provided here. The nurse would have to be an NP or nurse midwife in order to meet the first requirement. The site of service cannot be in the home as a second requirement.

http://www.cms.gov/Outreach-and-Edu...NProducts/downloads/telehealthsrvcsfctsht.pdf
 
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Thank you for your reply! Yes, I know it does not qualify for telehealth or telemedicine it is a bit different. Would you have suggestions on how to code this scenario?
 
Unfortunately, I have little experience with billing home health services. If the provider did not provide the service face-to-face in person and you are not set up as a home health service entity, this was not a billable service.

Someone with experience with HHS rules and billing may have an answer for you.
 
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