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Telehealth, asyncronous “store and forward”

Hi all,

I hope someone can send me some guidance on my dilemma please read below:

I have searched and searched for billing guidelines for asynchronous ‘store and forward’, which does NOT fall under the telemedicine definition but rather telehealth. Let me explain my dilemma.

We have an Optho department that reviews images sent to a shared data bank. The optho doc does not see the patient in "live time" the patient is in a hospital with the "spoke" apart from the "HUB" provider. Images were taken of the patient, the results are entered into this databank and the consulting provider goes in and reviews the images and then reports back to the "spoke" provider.

My optho docs feel that they can bill an "E/M" code for this service. Our patients are primarily Medicaid (AHCCCS). How is this possible when an E/M is a "face to face" encounter? I understand the E/M codes can be billed when there is a live interaction (telemedicine) exchange between the spoke and the hub with the GT modifier. But what billing codes should they be using along with the GQ modifier (via asynchronous telecommunications systems)?

Any advice is greatly appreciated :)

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