Wiki Telehealth denials from Regence of Idaho

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skiboi

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Twin Falls, ID
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on a audio video platform from our EMR I'm billing E/M codes with modifiers, either or 95 or GT, POS 11 and the carrier has been denying this since the first of the year. Has anyone else been experiencing this same issue? Maybe with another payer? Thanks in advance.
 
Hi
Modifier GT has been stopped in use since last year. But check with differ payers but I d use modifier 95 with CPT Eval/Mgnt codes to signify telehealth. Also ensure the provider list how long minutes of discussion with the patient in documentation for the day and type of telehealth phone or video call. If direct phone calls use CPT 99441-99443 for MD, DO, NP ,PA and CNA licensed providers. The new CPT manual year 2022 will discuss this in depth in Appendix R or kinds of telehealth, video calls, and electronic medical equipment use (ie heart Holter monitor, sleep study machines).

I hope this data helps you

Lady T:)
 
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