kathleeng
Guru
I work for a Hematology/Oncology practice. We have started seeing patients by telehealth services. I have a question on my first one. We have a Consult for new patient done by audiovisual. Everything required for telehealth guidelines is in the note. However, I'm having a hard time distinguishing picking the level of care. Comp HPI, PF Exam, Low MDM but MD spent 60 minutes with more than 50% of time spent counseling and coordinating care with the patient. Now I know that typically by coding guidelines of time spent, it would be a 99205, but I have a hard time giving the highest level of care because if I was to go by elements, then it meets a 99203. I know we can typically do either/or, whichever is higher, but I'm always careful on selecting highest level of care. Our doctor is going to question my reasoning for not selecting the highest level of care since time spent meets it. Any opinions on this? Of course, We would bill under POS 2 and appropriate modifier. Patient has Sharp Community Medical Group insurance, which is San Diego based private insurance so I believe the modifier would possibly be 95, instead of GT.....?
