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Quality Payment Program participation gets a little easier in some ways, tougher in others. A proposed rule published in the Aug. 17 Federal Register outlines potential changes to the Quality Payment Program (QPP) starting Jan. 1, 2021. Rather than implementing certain provisions finalized last year, however, the Centers for Medicare & Medicaid Services (CMS) is […]
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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 
There is a super cute little toy shop in Coeur d’Alene, ID called Shenanigan’s Toy Emporium that sells vintage toys and other unique items. When traveling there on business, we usually make a stop in to shop from their wall of amazing salt water taffy and check out their selection of toys that don’t come with a power button. You know, the kind of toys we had prior to the Atari and Game Boy era!
Shenanigan’s also has a great display of giant microbes – small plush renderings of everything from the common cold to diarrhea. I am still marveling at how they could create a plush toy out of liquid stool! I’m sure it’s just the geeky coder in me (and my colleagues), but we decided to buy a few and put them out during our training sessions along with our baskets of Play Dough, pipe cleaners, and candy (we like to have FUN in our training sessions!). Needless to say, they were a big hit with our clients and we noticed on one of the tags that there was a website where we could order more. By now your interest is surely piqued, so be sure to check out the online Giant Microbes store.
You’re probably thinking what I’m thinking right about now, which is, wouldn’t these giant microbes make great white elephant gifts for Christmas? My thoughts immediately went to what would be appropriate for my family’s white elephant gift exchange. Don’t worry, my family has a great sense of humor – there’s still a copy of Pamela Anderson’s novel (yes, she wrote one) complete with the “naughty” pages clipped together courtesy of my grandmother who was sheltering her daughter from the filthy parts. And what better gift for someone in 2014 than the Ebola virus? There’s just one problem.
Sold out.
Apparently I am not the only person who thinks that Ebola would make a great Christmas gift. It’s a sign of recent headlines that this virus, which is actually kind of cute in plush form, is unavailable. What’s even more worrisome given that this was the year Ebola came to the US, is that we don’t have an ICD-9-CM code to report it. Here’s the best we can do in ICD-9:
What about ICD-10-CM? How about this?
YESSSSSS! Way more specific!
In previous years as we’ve prepped for ICD-10 implementation, the opponents have given a laundry list of extensive and admittedly ridiculous (yet fun!) ICD-10 codes that begged the question, why do we really need this? And this year, Ebola was delivered to our health system and we have nonspecific codes to report it. But in ICD-10, we have a very specific code. Hmm. Perhaps this ICD-10 thing really could help with reporting and impact patient care. Just a thought.
So Santa, if I can’t have Ebola for Christmas this year, could I please have ICD-10 so that I can code it for those people who did get it?
Author’s Note: I am not affiliated with Shenanigan’s Toy Emporium or giantmicrobes.com in any way. I am just a really big fan!
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