Telehealth Coding System: Changing Rules & Guidelines

Posted on 3 Apr, 2017 |comments_icon 0|By Jeff G Lawson
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telehealth-coding

Incorporate new POS code for telehealth services.

According to a recent report by Zion Market Research, the global telehealth market will increase to as much as 12 million toward the end of 2022, a sign of the growing acceptance of remote medical services.

Change Request (CR) 9726 updates recently replaced the place of service (POS) codes with a new code (POS 02) for telehealth services. As per the latest rule that CMS declared, while reporting a new telehealth POS code, a service provider must indicate that the service is furnished from a distant site.

You may continue to use a CPT® or HCPCS code for the professional service, along with  modifier GT (Via interactive audio and video telecommunications systems). For example, if you report 99201(Office or other outpatient visit for the evaluation and management of a new patient…), use  GT to indicate the remote E/M service your provider rendered.

When appending GT to a covered telemedicine procedure code, you must ensure that the receiver has been present at an initiating site when you performed the telemedicine service.

If you append r GT to a covered ESRD-related service code, you may have to ensure that you provided one ‘hands on’ visit each month to check the vascular access site.

For federal telemedicine demonstration programs in Alaska or Hawaii, along with the CPT® or HCPCS code, you are required to submit modifier GQ, for telehealth services (Via an asynchronous telecommunications system). For example, if you report 99201(Office or other outpatient visit for the evaluation and management of a new patient…), use GQ for a remote E/M service your provider rendered..

Similarly, with appending GQ to a covered telemedicine procedure code, practitioners in Alaska or Hawaii will have to state that the asynchronous medical file was collected and transmitted at the distant site from a federal demonstration project. In both states, asynchronous “store and forward” technology is only valid in federal telemedicine demonstration programs.

Final Takeaway:

Despite the huge challenges surrounding telemedicine, it has immense potential to capture the global health market. To safeguard your success in telehealth, remain aware of the latest coding and billing rules, as well as compliance requirements. Choosing expert assistance from your trusted medical coding and billing go-to source will help you bypass the risks and pitfalls inherent to this evolving frontier.

You can learn more about telehealth from The Coding Institute in the Telehealth and Telemedicine Primer to be released fall 2017. Check our site for updates at www.codinginstitute.com.

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