Outpatient Facility Coding Alert - 2021 Issue 3
Telehealth: Learn These Facts, Clear up Telehealth Confusion
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Article Overview
This premium article addresses common telehealth coding and documentation questions that arose during the COVID-19 public health emergency. It summarizes guidance discussed in an NGS Medicare webinar, including general documentation expectations, place of service handling, patient status considerations, and how to think about post-PHE telehealth policy. It is useful for coders, billers, and clinicians who need to understand how telehealth rules were being applied during the PHE and what was expected to happen afterward.
Why This Topic Matters
Telehealth policies changed rapidly during the COVID-19 public health emergency, creating uncertainty around documentation, billing, and when services could be reported. This article helps coding professionals understand the scope of the guidance being discussed and identify which telehealth topics were most affected.
Article Sections
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First, a Word on Telehealth Documentation and the PHE
Overview of documentation expectations for telehealth encounters during the public health emergency, including general recordkeeping and visit-identification considerations.
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Can GE Modifier Allow Residents to Report Phone Codes?
Discussion of resident reporting questions in a teaching setting during the public health emergency and how the issue was being framed by the webinar presenters.
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Can You Differentiate 99441 Series From 98966 Range?
Comparison of telephone-based reporting questions for different practitioner types during the public health emergency.
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Will Practices Eventually Return to Pre-PHE Rules?
General explanation of how telehealth policy was expected to change after the public health emergency ended.
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Should You Resubmit Claims That Are Missing Modifier 95?
Discussion of claim correction concerns related to telehealth reporting during the public health emergency.
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Can You Determine the POS for an ED Service?
Question-and-answer coverage of place-of-service handling for telehealth services in an emergency department setting.
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How Should You Document Time in 2021?
Overview of time documentation considerations for telehealth services under the 2021 E/M framework.
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Are Telehealth Patients Then Considered “Established?”
Discussion of patient status questions for telehealth encounters and later office-based follow-up care.
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Can Practices Report Prolonged Service Codes for Phone Calls?
Coverage of prolonged service questions tied to telephone-based E/M reporting and related outpatient time concepts.
What You Will Learn
- How telehealth documentation was being addressed during the COVID-19 public health emergency
- What general telehealth billing topics were discussed by NGS Medicare
- How practitioners were asking about telephone-based E/M reporting during the PHE
- What issues were raised about place of service, patient status, and time documentation
- How post-PHE telehealth policy expectations were framed in the article
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Physicians
- Nurse practitioners
- Licensed clinical social workers
- Telehealth program administrators
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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