b'Telehealth CODING Update Compliancefor Chiropractic By David Kein ANJC Coding & Compliance Consultant PracticesLEGAL NUTRITIONUpdateWith the advent of the Covid-19 pandemic, many offices are seeingA text only email messagean increase in cancelled appointments and some are even facingA fax transmissiontemporary closure. What are your options? Most of your patients still An audio-only telephone consultation need the care and as a small business owner, you need to still pay the bills. Hopefully the information below can help you get a better senseSome states leave the rules up to the payors, therefore we encourage of the issues surrounding your practice and telehealth. Keep in mind News! you to check with your state and the health plan before attempting to that circumstances are constantly changing and this information isbill for telehealth.current as of press time. NUTRITION LEGAL EASE Notably on January 1, 2020 the AMA released a new set of CPT Telehealth codes for online digital Evaluation and Management (E/M) services. Though it may have limited application in a chiropractic setting,They vary in value from $16 to about $55 based on Medicares fee telehealth could be a way to keep patients and providers safe whileschedule and its likely that private payer reimbursement will be still hopefully generating a little revenue from delivering healthcarehigher. These are patient-initiated digital communications that require from a good social distance. It could also actually improve patienta clinical decision that otherwise would have been typically provided in the office. The codes for physicians are as follows:compliance by enabling patients to interact with providers when it9 REHAB Council may be difficult or impractical to see them in person.9421 - Online digital evaluation and management service, for an To that end, and in response to the Covid-19 pandemic, the HHSestablished patient, for up to 7 days, cumulative time during the 7 Office for Civil Rights (OCR) announced on March 17, 2020, that itdays; 5-10 minutes will waive potential HIPAA penalties for good faith use of telehealth99422 - Online digital evaluation and management service, for an during the nationwide public health emergency. Normally, providersestablished patient, for up to 7 days, cumulative time during the 7 would have to use a secure means of communication. However, withdays; 11-20 minutesLEGAL Q&A CHIRO Assistthis announcement, non-HIPAA approved technologies like Skype99423 - Online digital evaluation and management service, for an and FaceTime can be used. (Facebook Live, TikTok, and similar videoestablished patient, for up to 7 days, cumulative time during the 7 communication applications are public facing, and should not bedays; 21 or more minutesused in the provision of telehealth by covered health care providers.)For non-physician practitioners such as physical therapists and See HHS Notice for HIPAA for more details, and remember thatoccupational therapists the codes are as follows:these are temporary measures and providers should keep in mind that non-HIPAA approved technologies will not be allowed when98970 - Qualified non-physician health care professional onlineemergency ends. digital evaluation and management service, for an established Legislative Update patient, for up to 7 days, cumulative time during the 7 days; 5-10 Additionally, the Trump administration lifted national restrictions thisminutesweek on the use of telehealth which had previously limited Medicare telehealth programs largely to rural areas. It appears that the relaxed 98971 - Qualified non-physician health care professional online rules are to stay in effect as long as the pandemic lasts. Coverage is tominutes TECHNIQUE Councildigital evaluation and management service, for an established be retroactive to March 6, the date Congress passed, and Presidentpatient, for up to 7 days, cumulative time during the 7 days; 11-20 Trump signed, an emergency $8.3 billion Covid-19 spending bill. Many private payers recognize the potential cost savings and98972 - Qualified non-physician health care professional online improved health outcomes that telehealth can help achieve, thereforedigital evaluation and management service, for an established they are often willing to cover it. However, not every state haspatient, for up to 7 days, cumulative time during the 7 days; 21 or enacted parity laws which require private payers to cover telehealth tomore minutesUpdate * According to the AMA, CMS disagreed with the CPT Editorial Panel the same extent as face-to-face services, and the rules about how it isOUR HEALTHenforced vary from state to state. For example, Pennsylvania remainsthat codes 98970, 98971, and 98972 could be performed by qualified one of only a few states that does not require private insurers to covernon-physician healthcare professionals based on statutory requirements telehealth programs. However, in neighboring New Jersey, it appearsthat govern the Medicare benefit and do not allow nonphysicians to report insurers must provide coverage and payment for health servicesE/M services. CMS created parallel HCPCS G-codes with descriptors that delivered through telehealth or telehealth on the same basis as whenrefer to the performance of an assessment rather than an evaluation. the services are delivered through in-person contact and consultationFor 2020, CMS will provide separate payment for the nonphysician online (see NJ Statute C.26:2S-29 for full rules and requirements).digital assessments with HCPCS G-codes G2061, G2062, and G2063.It appears that all states with parity laws require private payerThe complete guidelines can be found in the AMA CPT codebook. reimbursement for live video encounters, while only some requireHowever, the key requirements for these codes for both physicians coverage for asynchronous, or store-and-forward encounters. Noteand non-physicians are as follows:that typically audio-only interaction is not covered. This includes:10 I Spring 2020 www.anjc.info'