Wiki Telephone Visit - Can this be an E/M per 2021 Guidelines

[LeaHarris]

My nurse care manager traveled to a patient's home and completed a visit. The idea was for the visit to be a shared visit with the patient's PCP zooming in at the last part of the visit via telemedicine. The provider ended up only being able to call via telephone and complete the shared visit. Since face-to-face is not required in the 2021 guidelines, can I bill the visit with the appropriate work complete as an E/M or am I stuck with the telephone visit CPT codes?

 

[beulastella]

This case should be coded only With telephone services.

 

[MeanderingMichigander]

Depends on the patient's insurance. You could bill an E/M for the PCP if the patient doesn't have traditional Medicare or Aetna. (You'd have to double-check the carrier's particular guidelines on phone visits to make sure, of course).

 

[mrymry402@yahoo.com]

Because of the PHE, telephone visits are billed as e/m visit.. per state mandate until 02.07 in Washington State.

 

[csperoni]

Because of the PHE, telephone visits are billed as e/m visit.. per state mandate until 02.07 in Washington State.

Interesting. I was not aware of any state that mandated audio only to be billed as E/M. I didn't see any mention of this in CMS documents.

 

[mrymry402@yahoo.com]

Interesting. I was not aware of any state that mandated audio only to be billed as E/M. I didn't see any mention of this in CMS documents.

There is a webinar in the AMA site about this was offered in preparation for the 2021 changes last October.. There is a waiver from CMS from April of last year.