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  • Telehealth Billing

    Over the weekend, an established patient contacted the ophthalmologist about an issue the patient was experiencing. The physician attempted to set up a telehealth conference since the patient couldn’t meet at the doctor’s office. However, the patient did not have access to video on a computer or cell phone. The doctor evaluated the patient by phone instead. There was no follow-up visit planned. How can this consultation be billed?

    Answer: It is not appropriate to bill evaluation and management (E/M) as it was audio only. Telephone services (audio only) 99441-99443 are used for care initiated by established patients or guardian of an established patient. If the call refers to an E/M that was reported for the patient within the last seven days or is post-op-related, it is not separately billable. If the telephone service ends in a decision to see the patient within 24 hours or next available urgent appointment, the code is not reported. Appending modifier -93, audio only, is payer dependent; verify with the payer's telehealth policy.
    Additional information can be found on our webpage for telehealth services Coding for Telemedicine.