星空入口

Question: If a telehealth visit was converted to an audio-only visit due to technical difficulties with the video component, should this still be billed as a phone visit even though the patient didn鈥檛 initiate it? This was for an established patient.

Florida Subscriber

Answer: Yes, if a telehealth visit is converted to an audio-only visit due to technical difficulties with the video component, it should be billed as a phone visit. The deciding factor is the method of communication used during the majority of the visit, not whether the patient or provider initiated the change. However, it's important to note that the reimbursement rates may differ between telehealth visits and phone visits.

For example, if the video visit fails at the beginning of the appointment, the provider should communicate with the patient that they will continue the visit over the phone instead. The provider should then clearly document that due to technical difficulties, the patient agreed to continue the appointment via phone instead of video. You should then code the appointment accordingly. Also, be sure that the provider clearly documented the length of the phone call for coding purposes. Based on the amount of time spent during the phone call, you would then choose from the established patient codes below:

• 98012 (Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 10 minutes must be exceeded.)
• 98013 (鈥� low medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.)
• 98014 (鈥� moderate medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.)
• 98015 (鈥� high medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.)

Lindsey Bush, BA, MA, CPC, Development Editor, AAPC