Question Telehealth Audit Initiative for 2021

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Hello All. Maybe someone out there can offer advice.

I work within the Compliance Department of a healthcare facility. One of the compliance initiatives for 2021 is to audit telehealth visits (specifically billing codes). Would it be sufficient to audit the following : CPT Codes; 99441-99443, with the modifier 95 and the POS code 11? What would you audit> Appreciate any input.
 

TThivierge

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Lithonia, GA
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Hi
I would ensure the clinical provider document or add it is a telehealth visit or face time or phone call. Nature of complaint or Chief complaint should be added AND the final diagnostic code or day's treatment. Also the past history should be listed and this should be for established patient. Modifier 95 should be used if a video conference call with the patient 's approval /consent noted in record too or beforehand. Ok I hope this helps you.
Lady T:cool:
 
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Hobart, IN
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I have done our pro fee compliance audit and I actually separate the two sets. I run reports for 95 and GT modifier for telemedicine on office, inpatient, and wellness visits. 99441-3 for telephone since they have different criteria. Hope that helps. Brenda
 
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