Outpatient Facility Coding Alert - 2019 Issue 4
Telemedicine: Make the Right Call With These New Telemedicine Codes
Subscribe or sign in to view the full article.
Article Overview
This article explains a pair of newer CPT interprofessional communication services and places them in the context of CCI/NCCI edits and payer reimbursement uncertainty. It is aimed at coders, billing staff, and clinicians who need a broad understanding of how telemedicine-adjacent consultative services are being treated in claims review and payment policy. The discussion focuses on the general coding and reimbursement issues surrounding these services rather than on detailed claim examples.
Why This Topic Matters
These services may affect how providers document and report remote consultative interactions, while edit status and payer policy can determine whether claims are paid or denied. Understanding the article helps readers evaluate whether the topic is relevant to their coding workflow and reimbursement environment.
Article Sections
-
What Do the Codes Describe?
Introduces the newer interprofessional telephone, internet, and electronic health record services discussed in the article. The section contrasts the general purpose of the services and the roles of the professionals involved.
-
What do the CCI Edits Mean for 99451 and 99452?
Summarizes how the services are positioned within CCI/NCCI edit pairs and why that matters for claims processing. The section also addresses modifier indicator treatment in broad terms.
-
Payers Still Reluctant to Reimburse for Consultation Services
Reviews payer hesitation around non-face-to-face consultation services and discusses the broader reimbursement outlook. The section reflects on how adoption of communication-based services may evolve over time.
What You Will Learn
- The general purpose of newer interprofessional telemedicine-related CPT services
- How CCI/NCCI edit placement can affect reimbursement outcomes
- Why payer policies may influence whether these services are paid
- The broader context for consultation-style services delivered without a face-to-face encounter
Who Should Read This
- Medical coders
- Billing staff
- Reimbursement professionals
- Physicians and other qualified health care professionals
- Practice administrators
Codes Discussed
Subscribe or sign in to view the full article.


Quick, Current, Complete - www.findacode.com