Author: Lori Carlin, CPC, COC, CPCO, CCS, CRC
Principal

 

Author: Angela Wood, CPC
Senior Physician Auditor / Educator

 

(303) 801-0111


If you haven’t already, you should utilize the Medicare Preventive Services education tool from The Medicare Learning Network! Not only does it lay out all of Medicare’s preventive services in a very easy to use format, it also indicates which of these services can be performed using telehealth services by placing a “T” next to the description of the service.

Many know the Medicare Annual Wellness Visit (“AWV”) can be performed via telehealth, but are you aware Medicare allows screening and counseling for patients with alcohol misuse to be performed via telemedicine? To bill for this service, code the Healthcare Common Procedure Coding System (“HCPCS”) G0442 for annual alcohol misuse screening, 5 to 15 minutes, and G0443 for a brief face-to-face behavioral counseling for alcohol misuse, 15 minutes. The services are covered in National Coverage Determination (‘NCD”) 210.8. Per HCPCS guidelines, code G0442 can only be billed once per year. HCPCS code G0443 can be billed up to four (4) times per year if a patient screens positive for alcohol misuse. Because these are preventive services, the patient will not incur a co-payment, co-insurance, or a deductible.

Additionally, Medicare allows telehealth services for depression screenings. Coding Guidelines note to report code G0444 – annual depression screening, 5 to 15 minutes. The frequency for this service is once a year and there is no co-payment, coinsurance, or deductible. For more information reference NCD 210.9.

Additionally, G0296 (“Counseling visit to discuss need for lung cancer screening (LDCT) using low-dose CT scan”) can utilize telehealth services. This telehealth-friendly code is intended for patients aged 50-77, who are asymptomatic for lung cancer, and who also have a tobacco smoking history of at least 20 pack-years. The documentation must support the patient either being a current smoker or one who has quit smoking within the past 15 years. Per NCD 210.14, the frequency rate for this code is once in a calendar year. Just as with G0444, the patient will incur no co-payment, co-insurance, or deductible.

For more information regarding Medicare Preventive Services, please review the link provided below.

Keeping up with the rapidly changing rules of telehealth can be exhausting. PERCS is here to help you navigate guidelines to remain compliant. If you have any questions or need assistance, please contact Angie Wood, CPC, Sr. Physician Auditor and Educator at AWood@AskPHC.com or Lori Carlin, CPC, COC, CPCO, CCS, CRC, Principal, at LCarlin@AskPHC.com. They will be readily available to answer your questions and provide expert advice, so you are well equipped to move forward!

References:

https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html#LUNG_CAN