Coding Corner: Telehealth Services | Andrew W. Menzin, MD
The COVID-19 pandemic lead to a marked increase and expansion of the use of telehealth services, with more broad coverage for these encounters. During the past three years, clinicians have sought to determine appropriate clinical scenarios to employ these virtual encounters, expanding access to a variety of services and often improving patient experience.
Examples of telehealth encounters in the practice of ambulatory gynecologic oncology include:
- Pre-surgical discussion
- Review of testing results and further management planning
- Longitudinal follow-up assessment when an examination is not required
Various HIPPA-compliant platforms are available for such encounters. Health systems have aligned their electronic health records with these platforms, creating templates for documentation that ensure completion of required elements (e.g., patient acknowledgement/consent, participants in the encounters, the locations of both the provider and the patient).
Telehealth visits that have a video component are billed based either on the complexity of the medical decision-making or on the time spent for the encounter (inclusive of time spent attending to documentation). The relevant CPT codes are 99211 (<10 min), 99212 (10-19 min), 99213 (20-29 min), 99214 (30-39 min), 99215 (40-54 min). Of note, telehealth encounters that are only audio (telephone) are billed solely based on time.
Andrew W. Menzin, MD, MBA, FACOG, FACS, is a gynecologic oncologist at Northwell Health in Manhasset, NY.
The SGO Coding and Reimbursement Subcommittee invites you to join us for the 2023 Coding Course during the 2023 Annual Meeting on Women’s Cancer on Friday, March 24, 2023, in Tampa, FL. Topics will include:
- changes to hospital and outpatient Evaluation and Management (E/M) coding with an emphasis on documentation that differentiates Level 4 and 5 visits,
- detailed case studies of common inpatient and outpatient billing scenarios, and
- the basics of surgical CPT coding and the use of modifiers with cases of common and complex gynecologic oncology surgeries.
Bring your questions to ask our panel of experts during the lively Q&A.