Wiki About Telehealth

[EricRmi]

Good Day,

I'm new to reporting codes for Telehealth.

I did some research about Telehealth coding so may I please ask for some inputs or corrections.

Scenario:

The chart that I am reading only has "Telehealth f/u. Reviewed procedure day DOs and Don'ts." as the documentation for telehealth.

I learned that for Telehealth to be considered, it should be documented as patient-initiated. Not doctor-scheduled.

Also, Telehealth was performed three times (January 2, 6 and 9) within 7 days. Each consult is at least 30mins discussing everything.

The patient's payer is not Medicare, so I rerpoted 98006 for follow-up telehealth consults.

The patient charts looks like this:

Subjective
Chief Complaint
Review of Systems

Objective
Physical Exam
HEENT, Neck, chest, heart, abdomen, pelvic etc.

Assessment
Their official confirmed dx.
time spent 30mins ~~~

Plan
Plan of care.

So I reported 98006 then the confirmed dx.
=======================
With this, may I ask what did I miss? What information should I look for?

Thank you so much.

 

[jkyles]

Hi,
The documentation for an E/M telemedicine visit still has to hit the requirements for an E/M visit. You'll need to check the specific payer for guidance. But in general the doctor needs to indicate what they did to justify payment.

There are no patient initiation requirements or frequency limits for telemedicine codes 98000-98015. Those are limits for 98016.

 

[sls314]

Good Day,

I'm new to reporting codes for Telehealth.

I did some research about Telehealth coding so may I please ask for some inputs or corrections.

Scenario:

The chart that I am reading only has "Telehealth f/u. Reviewed procedure day DOs and Don'ts." as the documentation for telehealth.

I learned that for Telehealth to be considered, it should be documented as patient-initiated. Not doctor-scheduled.

Also, Telehealth was performed three times (January 2, 6 and 9) within 7 days. Each consult is at least 30mins discussing everything.

The patient's payer is not Medicare, so I rerpoted 98006 for follow-up telehealth consults.

The patient charts looks like this:

Subjective
Chief Complaint
Review of Systems

Objective
Physical Exam
HEENT, Neck, chest, heart, abdomen, pelvic etc.

Assessment
Their official confirmed dx.
time spent 30mins ~~~

Plan
Plan of care.

So I reported 98006 then the confirmed dx.
=======================
With this, may I ask what did I miss? What information should I look for?

Thank you so much.

CPT 98006 is synchronous audio-video. However, what you've shared does not specify that it is synchronous audio-video. The provider needs to be specific. Was it audio-video? Was it audio-only? "Telehealth" isn't specific enough about what kind of visit it was.

Also, was there more to the visit than telling the patient the procedure day DOs and DONTs? Remember that the standard of care for a telehealth visit is the same as the standard of care for an in-person visit.

If they're just calling to say "don't eat after midnight, bring a driver with you, and check in at the desk by 7:30 am on procedure day" that alone isn't an E/M visit.

Edit to add: Of course, I understand that you condensed and made the note more generic for purposes of an example - hopefully the full note does cover the points mentioned above.

 

[EricRmi]

Thank you so much for both of your answers. I truly appreciate it!

Requesting for thread closure if that is needed.