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| telemedicine [2025/01/29 15:46] – created Scott Larson | telemedicine [2025/04/18 20:40] (current) – external edit 127.0.0.1 | ||
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| ====== Telemedicine ====== | ====== Telemedicine ====== | ||
| - | ==== E&M Coding | + | * Codes describe real-time, interactive encounters between physician or other QHP and patient. |
| + | * Based on level of MDM or total time for E/M performed on date of encounter. | ||
| + | * Not used for routine telecommunications related to a previous encounter (eg, to communicate lab results). | ||
| + | * May be used for follow-up of previous encounter when follow-up is required. | ||
| + | * Medicare allows audio only when the practitioner is audio-video capable, but the patient declines or is unable to use video. This should be clearly documented in the medical record. | ||
| + | * Time being used for any E/M service should not be counted towards any separately billable service. (e.g. chronic care management or principal care management that accrues over a 30-day period) | ||
| + | |||
| + | ==== Audio-Video Calls ==== | ||
| ^New Patient Code^Description^ | ^New Patient Code^Description^ | ||
| |98000|**Synchronous audio-video visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, __15 minutes must be met or exceeded.__| | |98000|**Synchronous audio-video visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, __15 minutes must be met or exceeded.__| | ||
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| |98002|**Synchronous audio-video visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, __45 minutes must be met or exceeded__.| | |98002|**Synchronous audio-video visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, __45 minutes must be met or exceeded__.| | ||
| |98003|**Synchronous audio-video visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, __60 minutes must be met or exceeded__. | | |98003|**Synchronous audio-video visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, __60 minutes must be met or exceeded__. | | ||
| - | add the code 99417 for services | + | For service |
| ^Established Pt Code^Descriptionj^ | ^Established Pt Code^Descriptionj^ | ||
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| |98006|**Synchronous audio-video visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, __30 minutes must be met or exceeded__.| | |98006|**Synchronous audio-video visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, __30 minutes must be met or exceeded__.| | ||
| |98007|**Synchronous audio-video visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, __40 minutes must be met or exceeded__.| | |98007|**Synchronous audio-video visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, __40 minutes must be met or exceeded__.| | ||
| - | For encounters 55+ minutes | + | For encounters 55+ minutes |
| + | ==== Audio Only Calls ==== | ||
| + | ^New Patient Code^Description^ | ||
| + | |98008|**Synchronous audio-only visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, __15 minutes must be met or exceeded.__| | ||
| + | |98009|**Synchronous audio-only visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total time on the date of the encounter for code selection, __30 minutes must be met or exceeded.__| | ||
| + | |98010|**Synchronous audio-only visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, __45 minutes must be met or exceeded__.| | ||
| + | |98011|**Synchronous audio-only visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, __60 minutes must be met or exceeded__. | | ||
| + | For service that exceeds 74 minutes add code 99417 | ||
| + | ^Established Pt Code^Descriptionj^ | ||
| + | |980012|**Synchronous audio-only visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, __10 minutes must be met or exceeded__.| | ||
| + | |98013|**Synchronous audio-only visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total time on the date of the encounter for code selection, __20 minutes must be met or exceeded__.| | ||
| + | |98014|**Synchronous audio-only visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, __30 minutes must be met or exceeded__.| | ||
| + | |98015|**Synchronous audio-only visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, __40 minutes must be met or exceeded__.| | ||
| + | For encounters 55+ minutes add code 99417 | ||