Wiki Telemedicine Originating Site Billing Q3014

[Kristen Bensel]

If our facility is billing for being the originating site for a telemedicine visit, what would you suggest the ICD-10 would be for this charge? Would you want to use the diagnosis associated with the visit that the billing provider would use at the distant site? Or maybe something more along the lines of an administrative code- such as Z02.89? How about the Z76.89 Persons encountering health services in other specified circumstances? Maybe Z75.3 Unavailability and inaccessibility of other healthcare facilities?

I feel like I am grasping at straws as there really is not any guidance on this particular issue when it comes to billing this code- it all goes back to the specifics for the modifiers, POS, and who qualifies to bill it... but nothing on the diagnosis that should accompany that facility fee.

Any insight you may have on this is greatly appreciated. As this is something we are considering doing for our patients who can not travel as easily to specialists outside of our area. (we are located in a rural area with limited providers, specialist are generally 2+ hours away)

Thank you!

 

[thomas7331]

The diagnosis must be supported by documentation of the reason for the encounter and the problems or conditions being treated. Yes, in all cases I can think of it would be the same diagnosis that provider is using for professional services, since that is part of the same service. You don't need a separate diagnosis, such as the Z codes you're suggesting, to try to explain or justify the telemedicine service to the payer - you should assign only the codes that reflect what is in the record that the provider documented.

 

[Kristen Bensel]

Using the same DX as the outside provider was my original thought- as it would make sense that we are only hosting the patient for an outside providers visit so you would want the diagnosis to be the same- providing they send us the notes so we can know what they billed.
But wanted to make sure that was the appropriate way to go before I tell management that is how it should be. Thank you Thomas