The AOA\/AOIA webinar below, featuring Jill Young, CPC, CEDC, CIMC, was recorded on April 9, 2020.<\/p>\n
<span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n<p>View <a href=\"https:\/\/osteopathic.org\/wp-content\/uploads\/April-9-Coding-and-Billing-Telehealth-AOA-HANDOUT.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">slides<\/a> for this webinar, or read a summary below. To register for CME, please visit <a href=\"https:\/\/aoaonlinelearning.osteopathic.org\/course\/info.php?id=313\" target=\"_blank\" rel=\"noopener noreferrer\">AOA Online Learning<\/a>.<\/p>\n<ul>\n<li><a href=\"https:\/\/osteopathic.org\/wp-content\/uploads\/CMS-1744-IFC-03-30-20-FINAL-508c-highlighted.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">CMS Policy and Regulatory Revisions<\/a> in Response to the COVID-19 Public Health Emergency (referenced in webinar)<\/li>\n<\/ul>\n<div class=\"page\" title=\"Page 1\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p>In March, the Centers for Medicare & Medicaid Services (CMS) signed <a href=\"https:\/\/www.cms.gov\/Medicare\/Provider-Enrollment-and-Certification\/SurveyCertEmergPrep\/Downloads\/1135-Waivers-At-A-Glance.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Waiver 1135<\/a>, which brought on significant changes to telemedicine service qualifications, and billing and coding procedures, while the nation battles the novel coronavirus disease (COVID-19).<\/p>\n<p>Some insurance companies are following CMS\u2019 lead, but each has its own unique policies. Jill Young, CPC, CEDC, discussed these changes and reviewed what codes are now available for Medicare telehealth\/telemedicine services in an April 9 AOA\/AOIA webinar. View the\u00a0<a href=\"https:\/\/thedo.osteopathic.org\/wp-content\/uploads\/2020\/04\/April-9-Coding-and-Billing-Telehealth-AOA-revised-HANDOUT.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">webinar slides here.<\/a><\/p>\n<p><strong>What\u2019s new?<\/strong><\/p>\n<p>A lot\u2014an overview is below. Also, CMS\u2019 new policies are outlined in detail\u00a0<a href=\"https:\/\/osteopathic.org\/wp-content\/uploads\/CMS-1744-IFC-03-30-20-FINAL-508c-highlighted.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">here<\/a>.<\/p>\n<p>CMS added 80 new telemedicine codes for use during the extent of this public health emergency (PHE), backdated to March 1.<\/p>\n<p><strong>How does telehealth eligibility look different during COVID-19?<\/strong><\/p>\n<p>Previously, physicians had to consider a patient\u2019s location when coding for telemedicine under Medicare. During this PHE, the 1135 waiver has relaxed restrictions on originating sites, so patients can be in their homes or virtually anywhere within reasonable range of their physician.<\/p>\n<p>There have been no changes regarding which providers are eligible to provide services. However,\u00a0<span class=\"s1\">Medicare has a fast track application process. The possibility an applicant would be approved for temporary billing privileges during a call to CMS exists. Typical credentialing information is collected on the call with the waiving of several of the normal screening requirements.<\/span><\/p>\n<p><strong>How do these changes impact billing & coding procedures?<\/strong><\/p>\n<p><strong>Place of service (POS) & modifiers:<\/strong>\u00a0For all Medicare services backdated to March 1, instead of billing POS 02, as one normally would for telemedicine visits, bill the place of service where your provider would usually provide that code and service under normal circumstances.<\/p>\n<p>For instance, if a service would have normally been provided in your office, POS 11, that\u2019s what you should bill. To indicate that the service was done using telecommunication technology, use Modifier 95.<\/p>\n<p>If you bill POS 02 for Medicare telehealth visits, it will automatically reduce your pay. If you have done this already, you can complete a clerical error reopening using the online topic or appeals section of your MAC website to get the correct payment.<\/p>\n<p>Medicare says that if only audio, and not video, are possible for a telehealth visit, these code rules do not apply. The service would be a telephone call and newly payable by the Medicare codes 99441-99443. But on CMS calls, the possibility of additional changes to code requirements has been mentioned, without further detail or timelines. Other insurers have been more flexible, but physicians should research them individually.<\/p>\n<p><strong>Documentation:<\/strong>\u00a0Providers<span class=\"s1\">\u00a0can still use the documentation guidelines (1995 or 1997) they currently use.\u00a0<\/span><span class=\"s1\">Additionally,<span class=\"Apple-converted-space\">\u00a0<\/span>they may use the concept of MDM (medical decision making) alone or Total Time from the 2021 anticipated guidelines that have been approved for this PHE.<\/span><\/p>\n<p><span class=\"s1\">The Total Time concept from 2021 is provider time only in selecting a level of service, from the time they sit down with the chart or open a record. For the MDM concept of selecting a level of service, a clinically appropriate history and exam are still taken, but the documentation for those elements is not required.\u00a0<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">When deciding what order to put multiple modifiers in on a claim, the order is payment modifiers first, and informational second.<\/span><\/p>\n<p><strong>New COVID-19 code<\/strong><\/p>\n<p>The new confirmed COVID-19 diagnosis code, effective April 1, is: U07.1 \u2013 COVID-19.<\/p>\n<p>Find guidelines on how to use this code on the\u00a0<a href=\"https:\/\/www.cdc.gov\/nchs\/data\/icd\/COVID-19-guidelines-final.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">CDC website<\/a>. Quick relevant details:<\/p>\n<ul>\n<li>Code only confirmed cases: a positive test result, or a presumptive positive test result.<\/li>\n<li>Always sequence it first (except during pregnancy, child birth and the puerperium where codes from Chapter 15 always take sequencing priority), then follow it with appropriate codes for associated manifestations.<\/li>\n<li><span class=\"s1\">In the absence of a confirmed diagnosis, use the signs and symptoms the patient had for your diagnosis.<\/span><\/li>\n<\/ul>\n<p><strong>Other relevant changes during the PHE<\/strong><\/p>\n<p><strong>HHS and OCR relax restrictions:<\/strong>\u00a0Typically, patients are only eligible for telehealth services if they have a prior established relationship with a provider. But HHS is saying it will not conduct audits on that for now. Effectively, this allows providers to see new Medicare patients virtually. Old frequency restrictions for telehealth visits have also been waived.<\/p>\n<p>Additionally, the U.S. Office for Civil Rights has recently waived penalties for violating certain HIPAA Security and Privacy regulations through COVID-19. To learn more about that, please see the summary of the AOIA\u2019s April 6 webinar,\u00a0<a href=\"https:\/\/thedo.osteopathic.org\/2020\/04\/navigating-hipaa-and-telemedicine-during-covid-19\/\" target=\"_blank\" rel=\"noopener noreferrer\">Navigating HIPAA and Telemedicine<\/a>.<\/p>\n<p><strong>Patient consent:<\/strong>\u00a0Medicare doesn\u2019t require it prior to a telehealth service taking place, but it is required for certain parts of the service, like a virtual check-in. Young suggests having staff get consent every time and entering it into the record to be safe. Consent can be written or verbal.<\/p>\n<p>Additionally, patients must initiate contact with providers. Physicians can call and let patients know they are offering telehealth services if a patient has contacted them about an issue, but \u201ccold calls\u201d are prohibited.<\/p>\n<p><strong>Patient financial liability:<\/strong>\u00a0Typically, telehealth does not change the out-of-pocket costs for patients under Medicare, which means they are liable for copayments and coinsurance. Providers may now reduce or waive cost-sharing for telehealth visits paid for by federal health care programs. Young has advice for making sure you don\u2019t lose out on fees you are owed at 21:39 in the video above.<\/p>\n<p><strong>Deductibles:<\/strong>\u00a0Until further notice, HHS is not penalizing health insurers that amend catastrophic plans to waive copays and deductibles for COVID-19-related services.<\/p>\n<p>Many insurers are still figuring this out. Aetna, as an example, is not requiring patients to pay copays for telemedicine visits from March 6-June 4, and instructs coders to use either GT or 95 modifiers. Research individual payers to see what their policies are and note that they may change.<\/p>\n<p><strong>Licensure:<\/strong>\u00a0Physicians who are licensed in their home state can now see patients in other states under Medicare. Each state may still have other restrictions that need to be addressed. Be sure to check with your malpractice carrier before providing telehealth services in any state, including your own, to make sure you have the correct coverage.<\/p>\n<p><strong>Resources<\/strong><\/p>\n<p><a href=\"https:\/\/www.cchpca.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">Center for Connected Health Policy<\/a><\/p>\n<p><a href=\"https:\/\/www.telehealthresourcecenter.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">National Consortium of Telehealth Resource Centers<\/a><\/p>\n<p><a href=\"https:\/\/www.cms.gov\/About-CMS\/Agency-Information\/Emergency\/EPRO\/Current-Emergencies\/Current-Emergencies-page\" target=\"_blank\" rel=\"noopener noreferrer\">CMS Current Emergency Website<\/a><\/p>\n<p><strong>Technology options<\/strong><\/p>\n<p><a href=\"https:\/\/cerashealth.com\/aoa.html\" target=\"_blank\" rel=\"noopener noreferrer\">Ceras Health<\/a><\/p>\n<p><a href=\"https:\/\/www.bluestreamhealth.com\/rapid-response\/?utm_source=AOA&utm_medium=referral&utm_campaign=rapid_response\" target=\"_blank\" rel=\"noopener noreferrer\">Bluestream Health<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The AOA\/AOIA webinar below, featuring Jill Young, CPC, CEDC, CIMC, was recorded on April 9, 2020. \ufeff View slides for this webinar, or read a summary below. To register for CME, please visit AOA Online Learning. CMS Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (referenced in webinar) In March, the … <a href=\"https:\/\/osteopathic.org\/practicing-medicine\/telemedicine\/webinar-telehealth-billing-coding\/\" class=\"readmore\">Read More<\/a><\/p>\n","protected":false},"author":30513,"featured_media":0,"parent":21484,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.4 (Yoast SEO v21.4) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Webinar: Telehealth Billing & Coding - American Osteopathic Association<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/osteopathic.org\/practicing-medicine\/telemedicine\/webinar-telehealth-billing-coding\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Webinar: Telehealth Billing & Coding\" \/>\n<meta property=\"og:description\" content=\"The AOA\/AOIA webinar below, featuring Jill Young, CPC, CEDC, CIMC, was recorded on April 9, 2020. \ufeff View slides for this webinar, or read a summary below. 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