Otolaryngology Coding Alert

Question: How do I know which evaluation and management (E/M) codes are eligible for use as telemedicine codes?

New York Subscriber

Answer: As of 2017, CPT^® has simplified the process of identifying which evaluation and management (E/M) codes are telemedicine-eligible. In the 2017 CPT^® manual, you will find a new Appendix P which, according to CPT^®, offers a "summary of CPT^® codes that may be used for reporting synchronous (real-time) telemedicine services when appended by modifier 95 (Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system)."

Here is a list of just a few of the codes eligible for the use of modifier 95:

• 99201-99205, Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components...
• 99212-99215, Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components ...
• 99231-99233, Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components ...
• 99241-99245, Office consultation for a new or established patient, which requires these 3 key components ...
• 99251-99255, Inpatient consultation for a new or established patient, which requires these 3 key components ...

For the full list, check the Appendix P in your 2017 CPT^® manual.