Telemedicine Information for COVID-19

Benefits for COVID- 19:

• Flexible scheduling
• Work from anywhere
• Streamlined visits for providers and patients. This includes the following:
  • HIPAA compliant video
  • Patient self-scheduling
  • Patient intake with health questionnaire
  • Virtual waiting room
  • e-Prescribing with Surescripts
  • Credit/HAS/FSA card processing
  • Documentation and coding tools
  • Patient visit summary
  • Apple health integration
  • 24/7 provider and patient customer service

Medicare Coverage and Requirements

• Within the Coronavirus Appropriations Act during Certain Emergency Periods Act of 2020, certain telehealth requirements waived.
• The secretary of HHS is authorized to temporarily waive the originating site and geographic requirements for telehealth services provided to Medicare beneficiaries located in an identified “emergency area” during an “emergency period” when provided by a qualified provider.
• To qualify for the waiver, the provider must have treated the patient within the previous three years or be in the same practice (i.e., as determined by tax identification number) of a practitioner who has treated the patient in the past three years.
• The bill also lessens the telecommunications requirements by allowing Medicare beneficiaries to receive telehealth services via their smartphones (i.e., telephones that allow for real-time, audio-video interaction between the provider and the beneficiary). Because the federal government has declared a nationwide public health emergency as a result of the coronavirus, the waiver will apply across the country until there is no longer a nationwide public health emergency
• Beneficiaries can communicate with their doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit.
• Medicare pays for virtual check-ins for patients with an established relationship with a physician or certain practitioners where the communication is not related to a medical visit within the previous 7 days and does not lead to a medical visit within the next 24 hours.
• The patient must verbally consent to using the virtual check-ins and consent must be documented in the medical records prior to the patient using the service.
• Medicare also pays for the patients to communicate with their doctors using online patient portals.
• The individual communication, like the virtual check-ins must be initiated by the patients.

ICD - 10 Code for COVID-19:

To address the proper coding of COVID-19 cases prior to the implementation of a new diagnosis code, interim coding guidance regarding the application of existing ICD-10-CM codes has been developed by the CDC/NCHS and approved by the four Cooperating Parties (NCHS, AHIMA, American Hospital Association, Centers for Medicare & Medicaid Services). According to this interim coding guidance, an ICD-10-CM diagnosis code should first be assigned for the specific respiratory condition the patient has developed (such as pneumonia, acute bronchitis, or lower respiratory infection, not otherwise specified). Code B97.29, Other coronavirus as the cause of diseases classified elsewhere, should be assigned as an additional diagnosis code for confirmed COVID-19 cases. It is important to note that this code should only be assigned when COVID-19 has been confirmed, not when COVID-19 is merely suspected.

• For cases where there is a concern about a possible exposure to COVID-19, but this is ruled out after evaluation, it would be appropriate to assign diagnosis code Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out.
• For cases where there is an actual exposure to someone who is confirmed to have COVID-19, code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases, should be reported.