Wiki Telehospitalists coding

[DIVINE50]

We are billing for Telehospitalists but I am unsure how to bill observation admits.

I don't feel like we can use the G0425-G0427 codes as this states consultation/ip admission. The observation admit codes are being denied as not allowed with Place of Service 02 (telehositalists).

So I am wondering if we use the 99201-99215 codes.

Any help would be appreciated.

 

[thomas7331]

I responded to your question on another thread. It's my understanding that under CMS policy, admissions are not allowed as telehealth, as they are not on the list of covered telehealth services. I believe that this is intentional because if a patient's condition is serious enough to need hospitalization, the admission really requires an in-person service by a physician. I think it would be inappropriate to use other codes since that would misrepresent the service provided. Medicare has only approved consultations and subsequent hospital services for payment under telehealth arrangements, but if in doubt, I would recommend inquiring directly with the payer for clarification.

Here is the link to a helpful publication on this from CMS - the list of approved services begins on page 6:
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TelehealthSrvcsfctsht.pdf