QUESTION: What are requirements to use regular office visit codes (i.e 99213, 99214) with Telehealth? Can regular office visit codes be used for just a phone call between the provider and the patient?
ANSWER: No. The provider must use telecommunication application, which infers video and audio, however, they can use that via cellphone. This is causing the confusion. For example, Facetime counts through your cell phone, however, an audio only call does NOT count.
In the CMS chart below note the difference between virtual check-in (which specifically states telephone or telecommunications), however, in Medicare Telehealth visits it states telecommunication system (which infers audio/video both).
Also see a recent blog post on Implementing Telehealth Visits that includes a step-by-step guide on how to convert office-based encounters to Telehealth encounters during the current COVID-19 pandemic. Note that these rules may change post-pandemic as many changes relaxing existing rules were made on a temporary basis by CMS and commercial payers to facilitate patient access and minimize risk of infection.(i.e 99213, 99214)
This answer provided by:
Shannon DeConda, CPC, CPC-I, CPMA, CEMC, CMSCS
Shannon is the Founder and President of NAMAS (the National Alliance of Medical Auditing Specialists), a division of DoctorsManagement, LLC.
What to do next…
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- Read more: What can you expect from a coding and compliance review?
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