Wiki Telephone Visits

[ruthan]

Good Morning Everyone,
I am hoping someone can give me there thoughts.

If I have a patient with BCBS, BCN, Medicare Plus Blue and BCN Advantage... my provider performs a Telephone Visit (either to review lab tests, or just a follow-up) and patient would rather do the Phone visit instead of coming in due to the COVID and the public health emergency act. I have been using the normal OV level's (we do based on time) with Mod 95 to indicate a Telephone visit and POS 11 for office which is what Medicare/BCBS said to use. Now apparently for these visit's beginning next year BCBS, BCN Medicare Plus Blue and BCN Advantage now want these to be billed with a POS of 10. What are CPT's is everyone currently using the original OV levels or the phone visit levels ie. 99443? Any ideas greatly appreciated.

 

[jkyles]

Hi there, real-time audio-only visits ("telephone visits") initiated by the patient are reported with the telephone E/M codes (99441-99443). Visits conducted with real-time audio/visual connection through a smart phone are office E/M visits (99202-99215). At least until the PHE ends.

 

[thomas7331]

Hi there, real-time audio-only visits ("telephone visits") initiated by the patient are reported with the telephone E/M codes (99441-99443). Visits conducted with real-time audio/visual connection through a smart phone are office E/M visits (99202-99215). At least until the PHE ends.

Yes, that's been my understanding too. I have read that some payers have given the OK to code audio-only visits using the 99202-99215 E&M codes, but unless you have that clearly in writing from the payer, I would not code phone visits using these codes with the 95 modifier as that is not the definition of a telehealth service, which requires real-time audio visual technology.