In addition to scheduling and charting a telemedicine visit, your practice can also treat any phone note as though it could be a billable service.
If you are working with a patient on the phone and the call is not for scheduling, and is not a follow-up to an appointment that occurred within the past 7 days, it may be a billable service.
How do you use PCC EHR to perform a telemedicine phone call, record details on a phone note, and then bill the service on a claim?
Create a Phone Note and Then Bill For It
Read the procedure below to learn how your practice can treat every call as though it may be billable, and then how to bill it.
Create a Phone Note
First, a clinician at your practice documents a phone encounter with enough detail to cover telemedicine requirements.
Use the Subject field to reflect the main topic of the encounter. Include enough clinical information in the phone note to make a diagnosis.
Make note of all questions asked during the call, and all clinical information given. Include any reassurances offered. Include all topics covered during the conversation.
Periodically Review the Messaging Queue
Each day, your practice can review the phone notes to see if they can be billed.
Sort the Messaging queue and use filters to limit the list to appropriate items for the biller to review.
Open Each Phone Note and Assess Whether It is Related to Another Appointment
Open each phone note and check the Visit History to see if the patient had any related in-office appointments. For example, the call may be a followup for a previous E&M visit within 7 days prior, or the call may have resulted in a visit the following day. The rules depend on the specific code your practice would bill for the call.
If the patient has an in-office E&M (for example) near the time of the call, you can open the chart note and check the reason. If the visit reason was not related to the phone call, then both that visit and the phone call may be billable.
For precise guidance on the timing restrictions for each billing code, check your CPT manual. In general, if a phone call is within 7 days of an E&M visit for a related reason, you may not bill the call and should instead incorporate the work performed into the claim for the in-office E&M visit.
Open the Practice Management Checkout Program
checkout from the Daily Operations window in Practice Management.
Can I Post These Charges Right In PCC EHR?: PCC is adding functionality to the Post Charges and Billing tools in PCC EHR. As of PCC 8.12, your practice will need to use the Practice Management window to post charges and create a claim for a phone note. Alternatively, you could schedule the encounter in PCC EHR.
Find the Correct Patient and Create a New Encounter
Press F2 – Find Patient to pull up the record of the patient whose telemedicine encounter you are billing. From the patient’s encounter list, press F4 – Create Encounter.
Enter Visit Date, Visit Reason, Physician, and Charges
Within the new encounter, change the Visit Date to reflect the actual date the phone call took place. Select the Visit Reason, Physician, Diagnosis and Procedure Name for the service.
As you enter encounter charges, you can use other functions in
checkout to adjust copay, claim information, units, and more.
Post Charges and Queue Up a Claim
Press F1 – Next Step to save your charge and go to the next screen. When you complete your practice’s checkout workflow, you can press F1 – Post and Print to save encounter details and queue up an insurance claim.
Configure PCC EHR for Phone Note Billing
In order to get paid for telemedicine services provided over the phone, you will need to update the Phone Note Protocol in PCC EHR and add new Procedure Codes in Practice Management.
Revise the Phone Note Protocol
If you are not already tracking call duration and diagnosis within your phone notes, you will need to add these components to your existing Phone Note Protocol.
Open the Component Builder
Navigate to the Protocol Configuration tool, and select the Component Builder.
Create Duration Component
Add a new custom entry field for “Duration of Call (exact minutes)” to your Component Builder.
Duration vs Start/Stop: If you prefer, create two fields to track the Start Time and Stop Time of the call, rather than one Duration field. You just need a way to track the total minutes spent on the call.
Create Diagnosis Component
Add another custom entry field for “Diagnosis Treated in Call”.
Edit the Phone Note Protocol
Return to the Protocol Configuration and open the Protocol Builder to edit your existing Phone Note Protocol.
Add Your New Components to the Phone Note Protocol
Add your new duration and diagnosis components to the Phone Note Protocol.
Create a Telemedicine Procedure Groups and Procedures
To learn how to set up procedures, codes, and prices, read the configuration section of Schedule, Chart, and Bill a Telemedicine Visit in PCC EHR.
For more help in setting up new procedures, contact your PCC Client Advocate.
Telemedicine Billing Codes
PCC is maintaining a Guide to COVID-19 Billing Codes, which includes full descriptions of different types of telemedicine visits and how to code for them.