- Fill in the blank: The 2020 CPT manual contains ____ new codes for physiologic monitoring services.
- Fill in the blank: Codes 99421-99423 should be used to report _______________.
- Telephone conversations with patients
- Online E/M services
- Review of recorded images
- Interpretation of physiologic data
- When did Medicare start to cover interprofessional consults?
The answers are in the following article.
Providers’ interest in — and billing for — communications-based and remote physiologic monitoring services started before Medicare covered the services. A few very early adopters submitted claims for services such as E/M via phone, interprofessional consults and analysis of stored data in 2018, a review of the latest utilization data shows.
It’s no surprise practices jumped the gun. The services aren’t subject to the constraints of Medicare’s telehealth program and allow practices to recoup money for non-face-to-face services, such as a phone conversation with a patient.
Telephone E/M codes 99441-99443 were the most commonly reported communications services in 2018. Claims submitted for these codes would have amounted to approximately $458,000 in payments — if Medicare covered the services.
The popularity of the code for a five to 10-minute call (99441) may explain why CMS used the descriptor as a template for its first remote E/M codes and in 2019 introduced G2010 (Store and forward) and G2012 (Brief communication technology-based service, e.g. virtual check-in).
It's not obvious from the descriptors, but the technology covered by the services includes a telephone — or smart phone in the case of G2010 — Betsy Nicoletti, M.S., CPC, president of Medical Practice Consulting in Northampton, Mass., notes in the extra handout she created for attendees of the
Jan. 28 webinar on technology-based services.
Providers also reported — and were paid for 99091 (Collection and interpretation of physiologic data [eg, ECG, blood pressure, glucose monitoring] digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation [when applicable] requiring a minimum of 30 minutes of time). However, bundled code 99090 (Analysis of clinical data stored in computers [eg, ECGs, blood pressures, hematologic data]) was reported nearly twice as often.
Utilization data for 2019 won’t be available until September but it’s safe to assume that last year was a great year for the practices that were interested in remote services. Medicare coverage of remote services exploded, and private payers followed suit. In addition to creating two HCPCS codes for remote E/M services, Medicare began covering four revised and two new interprofessional consult services (99446-99449 and 99451-99452), three new services related to physiologic data (99453-99454 and 99457), and continued to cover a revised and relocated version of 99091.
The communications-based and remote service expansion continues in 2020, according to the slides Nicoletti prepared for Remote Control: Bring New Remote E/M Services Online in Your Practice.
Not only did Medicare ease the patient consent rules for the services, it added six new online E/M services (99421-99423 and G2061-G2063) and three new physiologic monitoring services (99473-99474 and 99458) to the list of covered services and once again private payers are following suit.
Now practices face a new challenge: Keeping up with all of the codes.