decisionhealth Newsletters, Part B News - 2020 Issue 5 (May)
E/M update: Navigate new vs. established patient distinctions during COVID-19
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Article Overview
This article reviews how COVID-19 public health emergency policies affected patient status distinctions for evaluation and management services delivered by telehealth. It is intended for coders, billing staff, and practices that reported remote E/M services during the emergency period and needed to understand the general scope of CMS guidance, affected service categories, and documentation/review considerations. The article also notes that these rules were tied to the PHE and discusses how practices may track claims internally for later review.
Why This Topic Matters
Correctly understanding patient status during the COVID-19 public health emergency affected telehealth reporting, internal claim tracking, and later audit readiness for practices that used remote E/M services.
Article Sections
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PHE guidance on patient status for remote E/M services
Overview of the public health emergency context and CMS guidance affecting how patient status was treated for certain remote services. The section introduces the issue and the time-limited nature of the policy.
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Examples of affected service types
Discussion of categories of evaluation and management services that were implicated by the guidance. The section distinguishes broad service types rather than detailing code-specific selection rules.
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Telehealth and visit category considerations
Summary of how patient status intersected with telehealth use across office, facility, and home-based services. The section also notes the temporary nature of the expanded coverage and its relationship to the end of the emergency period.
What You Will Learn
- How COVID-19 public health emergency policies affected new versus established patient distinctions
- Which general telehealth service categories were discussed in relation to patient status
- Why practices may want to track certain claims internally for later review
- How the article frames the temporary nature of the emergency-era guidance
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Physician practices
- Compliance/audit reviewers
Codes Discussed
Code Ranges Discussed
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