Part B Coding Coach: Figure Out How to Code for Virtual Care

Why This Topic Matters

Virtual care documentation and reporting rules can affect whether an encounter is billable and how it interacts with other services. Understanding the scope of the guidance helps coding staff apply the correct framework for online digital E/M encounters and avoid reporting conflicts.

Article Sections

1. Understand Context of Codes

   Introduces the article’s focus on virtual evaluation and management encounters and distinguishes between the main code groupings discussed. It also frames the service setting and the types of practitioners involved.

2. Remember 7 as the Magic Number

   Covers the timing and documentation framework discussed for patient-initiated digital encounters over a multi-day period. It also notes related considerations involving postoperative or global-period situations and recordkeeping.

3. Check NCCI Edits for Clarification

   Reviews the role of NCCI edit relationships in understanding how the article’s virtual care codes interact with office or outpatient E/M services. The section also references edit indicators and pairing patterns.

4. Document the Encounter Like This

   Provides a general example of the type of documentation elements expected for a digital encounter. It focuses on the kinds of record components that support reporting.

5. End of PHE Shouldn’t Affect Code Use

   Discusses the post-pandemic outlook for the code families covered in the article and their relationship to Medicare payment policy. It also places the guidance in the context of earlier CPT and MPFS development.