• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Is this billable?

Create Wiki
M

MaureenDL123

Networker
Messages
55
Location
Stony Point, New York
Best answers
0
Patient had a triage visit, and was seen by the Resident and discharged. The OB called the patient and I reviewed tracings from home but did not see the patient in person. I don't think this would be billable but I just want to make sure.

Thank you.
 
MaureenDL123 said:
Patient had a triage visit, and was seen by the Resident and discharged. The OB called the patient and I reviewed tracings from home but did not see the patient in person. I don't think this would be billable but I just want to make sure.

Thank you.
Click to expand...
As far as I can tell unless the teaching physician was virtually supervising, it is a no go. However, the teaching physician can bill for the personal service they did, but not take credit for what the resident did. The scenarios for 2025 as below"

Below are scenarios describing virtual supervision of residents:

In a rural area, the resident is providing services to a patient in-person, and the teaching physician is located at home and supervising virtually. (Permanent policy change to allow coverage and payment)

In an urban area, the resident is at the hospital providing telehealth services to a patient who is at their home, and the teaching physician is located at home and supervising virtually. (Expires December 31, 2024)

Teaching physician and resident are co-located in the same room at the hospital providing telehealth services to a patient at home or 3rd location in an urban area. (Expires December 31, 2024)

Resident is in-person with the patient providing services at the hospital in an urban area. The teaching physician virtually supervises the resident via video/audio technology from home. (No longer permitted: expired December 31. 2023
 
Thank you for the scenarios. I guess the Provider would need to write her own note then In order to bill it? Is just saying, ”Called the patient and I reviewed tracings from home and what was discussed enough and add a timestamp? I always thought if it was a call it had to be patient initiated? Sorry for all of the questions.

Thank you so much!
 
MaureenDL123 said:
Thank you for the scenarios. I guess the Provider would need to write her own note then In order to bill it? Is just saying, ”Called the patient and I reviewed tracings from home and what was discussed enough and add a timestamp? I always thought if it was a call it had to be patient initiated? Sorry for all of the questions.

Thank you so much!
Click to expand...
Please access this article for excellent information. Most of the telehealth codes require patient initiation but regular E/M telehealth does not. If would not call this documentation supporting much more than a 99211 at best. Sounds like there should be some inservice education regarding the newer rules with regard to telehealth for teaching physician scenarios. https://www.aafp.org/family-physici...-telehealth-audio-virtual-digital-visits.html.
 
I would like to add my 2 cents here. Melanie does provide some excellent references to be reviewed.
While it is possible this was a poorly documented billable service, in my experience, 99.9% of the time, this is simply the resident checking in over the phone with the teaching physician and would not be billable. Depending on how your practice runs, your experience could certainly differ.
 
You must log in or register to reply here.
Top