Issue link: https://viewer.e-digitaledition.com/i/1282067
CODING FOR VIRTUAL VISITS BY THOMAS CROCKER NE W CMS RULES AND WAIVERS E XPANDING THE USE OF TELEMEDICINE IN RESPONSE TO THE COVID-19 PANDEMIC HAVE LEF T PROVIDERS WITH QUESTIONS ABOUT CODING AND BILLING. IN A COLUMN for Medscape.com, medical cod- ing and compliance expert Betsy Nicoletti, MS, noted how to choose the correct level of service for a prima r y ca re telemedicine visit. She wrote that, according to new, emergency CMS rules for billing evaluation and management (E/M) services performed via telemedicine, "a practitioner could use total time or medical decision-making alone to select the level of E/M services." If a provider bases the selection on time, counseling no longer has to comprise the majority of the appointment. Nicoletti also explained the difference between HCPCS code G2012 and CPT code 99441 in response to a question from an OB-GYN office. Code G2012, she explained, is for a 5–10 minute phone or video visit for E/M services rendered to an established patient. These services cannot be related to E/M services provided during the previous seven days and cannot lead to an E/M service within the next 24 hours. Most insurers aren't required to use or accept G2012. Code 99441 carries the same stipulations as G2012, but is only for phone-based E/M services. In March, CMS updated its rules so that 99441 is now an active code rather than a non-covered code and is not considered a telemedicine code, according to Nicoletti. n Telemedicine Appointments Available V IDEO V ISITS PL AY ED a crucial role in allowing Syracuse Or thopedic Specialists to continue caring for patients during the COVID-19 pandemic. Telemedicine appoint- ments through the SOS Vir tual Visit App remains an option for initial and follow-up appointments, as appropriate, for patients who wish to see their or thopedic surgeon from the comfor t of home. a small generator to deliver mild, pain-relieving electrical impulses to the cervical or lumbar spine. Candidates include individuals for whom back surgery did not provide relief or who have chronic back or leg pain, degenerative spine changes, reflex dystrophy in the foot or knee, or painful neuropathies in the feet or hands, according to Dr. DiStefano. "Patients undergo a one-week tria l using electrodes placed percuta neously a nd a n e x t er n a l b a t t er y pa c k ," D r. D i S t ef a no says. "If that 's successful, we perma nently impla nt the electrodes in the spine through a sma ll incision in the upper or lower back. The wires are connected to a generator in the buttocks. Patients ca n adjust the streng th of the electrica l sig na l with a remote." The va r iet y of out patient spi ne proce- dures ava ilable at the Specia lists' One-Day Surger y Center is indicative of the sweep- ing nat ure of spine ca re at SOS. "O u r s i s a c omprehen sive s pi ne pr o - g ra m ," Dr. DiStefa no says. " We per for m pro c e du re s on a l l pa r t s of t he s pi ne i n i npa t ient a nd out pa t ient s et t i n g s , a nd we a lso of fer a w ide ra nge of nonsurg ica l treatments. Patients get a ll-encompa ssing ca re at SOS." For more information, visit sosbones.com or call 315-703-3442. n M D N E W S . C O M /// M D N E W S C E N T R A L N E W Y O R K ■ 2 0 2 0 1 7