Coronavirus has almost killed more than 10,000 people in Italy and now soon USA has become its main target. The death cases has crossed 3000 now due to COVID-19 cases. Medicare has now removed some restriction to help and treat the coronavirus cases immediately. At a time, when social distancing is among the major measures used to fight COVID-19 pandemic, telehealth is stepping-up as a key technology for safe and efficient communications.
Telehealth services has suddenly come to rescue during medical health emergency. The Centers for Medicare & Medicaid Services (CMS) lifted Medicare restrictions on the use of telehealth services during the COVID-19 emergency.
AMA kicked off a virtual panel discussion on telemedicine and COVID-19 where clinicians can give their input and share experiences.
Effective March 6 and throughout the national public health emergency, Medicare will pay physicians for telehealth services at the same rate as in-person visits for all diagnoses, not just services related to COVID-19.
ICD 10 codes for confirmed Covid 19 cases
Description of Telehealth services CPT code 99441, 99442 & 99443
Telephone or Telehealth services are non-face-to-face encounters originating from the established patient for evaluation or management of a problem provided by a qualified clinician. The problem may not be related to an E/M encounter that occurred within the previous seven days nor can the problem lead to an E/M encounter or other service within the following 24 hours or next available in-office appointment opening. Use CPT code 99441 for services lasting five to 10 minutes; CPT code 99442 for services lasting 11 to 20 minutes; and 99443 for calls lasting 21 to 30 minutes.
Scenario 1: Patient comes to office for E/M visit, is tested for COVID-19 during the visit
| Who is performing | Physician/QHP | |
| Applicable CPT Codes | 99201-99205 (New Patient) 99212-99215 (Established Patient) | |
| Applicable ICD-10 codes | Possible exposure to COVID-19 Z03.818  Actual exposure to COVID-19 Z20.828 | |
| Place of Service (POS) | 11 Physician Office | |
| Who is performing | Clinical staff (e.g., RN/LPN/MA) | |
| Applicable CPT Codes | Included in E/M | |
| Place of Service (POS) | NA | |
| Who is performing | Laboratory |
| Applicable CPT Codes | 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique |
| Place of Service (POS) | 11 Physician office 19 Off Campus Outpatient Hospital 22 On Campus Outpatient Hospital 81 Independent Laboratory |
Scenario 2: Patient comes to office for E/M visit re: COVID-19 and is directed to a testing site
| Who is performing | Physician/QHP |
| Applicable CPT Codes | 99201-99205 (New Patient) 99212-99215 (Established Patient) |
| Applicable ICD-10 codes | Possible exposure to COVID-19 Z03.818 Actual exposure to COVID-19 Z20.828 |
| Place of Service (POS) | 11 Physician Office |
| Who is performing | Testing Site |
| Applicable CPT Codes | 99001 Handling and/or conveyance of specimen for transfer from the patient in other than an office to a laboratory (distance may be indicated) |
| Place of Service (POS) | 15 Mobile Unit 17 Walk-in Retail Health Clinic 20 Urgent Care Facility 23 Emergency Room Hospital |
| Who is performing | Laboratory |
| Applicable CPT Codes | 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique |
| Place of Service (POS) | 11 Physician office 19 Off Campus Outpatient Hospital 22 On Campus Outpatient Hospital 81 Independent Laboratory |
There are around 11 scenarios in this special coding advice released by AMA. Below is the link for this document.
https://www.ama-assn.org/system/files/2020-03/covid-19-coding-advice.pdf
References:
https://www.ama-assn.org/practice-management/digital/ama-quick-guide-telemedicine-practice
[…] Attentive physicians and coders will note that the pathology and laboratory section of the CPT code set already contains codes for coronavirus testing. But those are for nucleic acid assays that detect multiple respiratory viruses in a multiplex reaction, while CPT code 87635 is for the detection of SARS-CoV-2 (COVID-19) and any pan-coronavirus types or subtypes. Read also: Examples of COVID 19 coded cases with answers Telehealth services used for Covid 19 cases in Public health Emergency […]
[…] Telehealth services codes to be used in COVID 19 health emergency […]