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Telehealth

Marilyn Posted Thu 26th of March, 2020 13:35:35 PM
Regarding Carona virus pandemic, for Behavioral Telehealth service(90791, 90837, 90834) via "telephone call" for patients who are unable for Interactive/Audio and Video sessions, would we append modifier "GQ" for non face to face, Or will this fall under Interactive /Audio? What is Asynchronous Telecommunication?
SuperCoder Answered Fri 27th of March, 2020 07:02:19 AM

Thank you for your Question.

 

 

Yes, Modifier GQ can be appended with telemedicine approved codes for services provided via asynchronous communication.  As per CMS, Medicare beneficiaries will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling and preventive health screenings. This will help ensure Medicare beneficiaries, who are at a higher risk for COVID-19, are able to visit with their doctor from their home, without having to go to a doctor’s office or hospital which puts themselves and others at risk.

 

Asynchronous communication means ‘store and forward’ technology would be used. It states transmitting medical information to a physician or practitioner who reviews it later. Modifier GQ denotes healthcare services provided via an asynchronous communication method. Asynchronous communication does not take place in real-time. An example of delivery of service via asynchronous communication includes a provider at a distant location, even in another state, who receives X-ray images transmitted across a secure network and then transmits the report of his reading of the images for later review by the patient's primary care provider. An exchange of email between a patient and a provider also constitute asynchronous telecommunication services.

 

 

Hope this Helps!

Marilyn Posted Tue 14th of April, 2020 16:01:18 PM
Some insurance are stating to use POS -02 or 11 for tele. Were confused. What's the difference?
SuperCoder Answered Wed 15th of April, 2020 04:43:01 AM

 

Thank you for your Question.

 

 

During this COVID-19 crisis, Medicare would be paying the non-facility amount for telehealth services when they are billed with the place of service (POS) the physician would have used if the service had been provided in person (e.g., POS 11 – Office). As per CMS, Place of Service (POS) equal to what it would have been had the service been furnished in-person.

Claims with POS 02 (regardless of physician or provider location) – Telehealth would be paid at the normal facility rate, which is typically less than the non-facility rate under the Medicare physician fee schedule.

 

Commercial payers are generally following Medicare’s lead in terms of coverage and policy. However, coding guidance varies from payer to payer.

 

Hope that Helps!

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