Could someone assist me with the new policy for billing Audio-only visits (99441 - 99443) in an Independent clinic after the Public Health Emergency (PHE)? I've encountered denials from UHC and Medicaid-Mississippi stating that these services are no longer covered. I've reviewed their state policy, and indeed, coverage seems to have ended after the PHE. How should I go about resubmitting these denied claims? Is it possible to crosswalk these codes to televideo E/M visits (99212-99215 with modifier 95) for billing?
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Wiki POST PHE BILLING OF AUDIO ONLY ENCOUNTERS
- Thread starter areesharizwan@gmail.com
- Start date
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- Tags
- denial insurance phe telehealth
CBLENNIE
Expert
I'm confused as to how you can convert the coding of an audio only visit to a televideo E&M visit. Based on your statement that the visits were audio only there is no video component to be used to convert the visit to a televideo E&M visit. Am I missing something here?
I'm seeking opinions on how to handle these denied insurance claims, specifically in relation to audio-only telehealth visits under the new policy. Currently, we've put all claims on hold as we plan to educate providers about the updated telehealth policy. However, I'm concerned about the denied claims from UHC and Medicaid-MS. There are numerous claims that providers are expecting reimbursement for. What options do we have to potentially secure payment for these denied claims?
daspray
New
You cannot crosswalk an audio-only service to an audio/visual CPT code as that is not the service that was performed. Does the denial remittance state PR for patient responsibility or CO denial that needs to be written off?