Use 8 more tips for telehealth coding during the public health emergency

by: Julia Kyles, CPC Jun 2, 2020

Medicare issued an update to its COVID-19 fact sheet May 27, and it contains more answers your telehealth documentation and coding questions.The topics relevant to Part B billing range from modifier use to how to report a telehealth encounter if the practitioner or the patient experience technical difficulties.

Remember: Even though states are lifting stay-at-home restrictions, the public health emergency is still in effect and practices can continue to treat Medicare patients under the relaxed telehealth and communications-based service rules during that time. Here are eight tips we gleaned from the update:

You do not need a separate patient consent to perform telehealth services. You will need it for services such as virtual check-ins (G2012) or interprofessional consult services (99446-99452) if you have not already received and documented the patient’s consent for such services this year.
Append cost-sharing waiver modifier CS and telehealth modifier 95 to telehealth claims when the encounter took place on or after March 18 and the purpose of the encounter was to determine whether the patient needs a COVID-19 test or to order a COVID-19 test for the patient.
Don’t add disaster modifiers CR or DR to your telehealth claims.
The non-covered codes on the list of telehealth services are still non-covered for Medicare. Services such as psychophysiological therapy (90875) and health behavior interventions with a family member when the patient is not present (96170-96171) were added in response to stakeholder requests, Medicare says.
Documentation rules for face-to-face services apply to telehealth services. “We expect the same level of documentation that would ordinarily be provided if the services furnished via telehealth were conducted in person,” Medicare says.
You won’t get extra pay when a telephone call goes past the 30-minute maximum for codes 99443 or 98968. According to the CMS fact sheet “there are no CPT codes available to describe medical discussions lasting longer than 30 minutes.” Keep in mind that some parts of the call may not count towards the encounter. If a patient and practitioner spend a couple of minutes greeting one another at the start of the call, five minutes on medical discussion, 20 minutes discussing politics, 10 minutes on medical discussion and wrap up with 10 minutes about their vacation plans, that’s a 15-minute encounter.
Prepare for dropped video connections during a telehealth encounter. Tell practitioners to note when the video link was lost so you can code the encounter based on the primary type of connection – audio-only or a two-way, real-time audio and visual connection. The fact sheet does not define “primarily,” but it’s a safe bet that practices should switch to an audio-only code if the video link was cut off before the halfway point of the encounter.
Follow the same documentation and coding rules for a service when a patient uses a teletypewriter (TTY) or other communication device designed for people with hearing or speech impairments during a telephone or telehealth encounter. In addition, practices cannot charge patients extra because they use communication aids.

Editor’s note: Check the blog tags for Breaking News, COVID-19 and Telehealth if you want to get caught up with our COVID-19 coverage.

Blog Tags: COVID-19, telehealth

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