Telemedicine Today

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Valerie Sheety-Pilon, OD

Imagine being asked a month ago, “How would you feel about managing the care of your patients from the phone or the web?” I would hazard to guess that few of us had considered it a real possibility. COVID-19 awakened our industry to the applicability of remote care, while the government’s injunction of telehealth waiver 1135 made it a reality overnight.

Some say telehealth services, across all medical verticals, could have been adopted long ago. Though for good reason, telemedicine has been governed by strict regulations. Like me, many of you may have been watching the industry grapple with a position on this topic.

Recently however, in response to the national public health emergency, the Centers for Medicare & Medicaid Services (CMS) broadened access to Medicare telehealth services to empower medical providers to serve patients. With millions of people currently sheltering in place, many are finding it necessary to leverage digital and social platforms to stay connected. During this uncertain time, it is comforting to know that we can still engage with our patients. It may not be in the way that most of us have come to appreciate over the years, nevertheless telemedicine is proving to be a valuable resource in managing emergent care of our patients.

This means that essential eye care can be delivered differently, and far more quickly. Whether it’s diagnosing conjunctivitis or extending refills on a prescription, we are now able to provide remote care for consultations, supervision, and medication management. Offering virtual patient visits enables us to address immediate eye care issues and allows us to play a critical role during this global pandemic.

To help practices manage the unique challenges of implementing virtual care, and provide industry-specific tools so we as doctors of optometry can focus on our patient’s needs, Eyefinity has released new telemedicine functionality within Eyefinity EHR. With the integrated telemedicine capabilities in Eyefinity EHR, providers are able to practice within the new, temporary regulatory guidelines, and efficiently document and code virtual patient visits. It also supports the ability for providers to expand practice reach.

The Criticality of Accurate Documentation and Coding

Patient records must be maintained in a manner consistent with telemedicine standards of practice, and must conform to all applicable laws and regulations. At the onset of any telemedicine patient encounter, initiated by the patient, remember it’s necessary to obtain verbal or written consent. Be sure to document the date and the time spent in the telemedicine exam, including whether the exam was conducted by phone or video. I recommend also annotating what modality/video platform you used, if any. As you would during an in-office exam, record the chief complaint, assessment and plan that is reflective of your encounter. It’s important to understand proper coding for telemedicine visits and billing modifiers—including place of service (POS). Prior to COVID-19, additional criteria for offering a telemedicine exam were required, such as patient location and provider location. At this time, however, these are not necessary with the CMS Interim Final Rule published March 30, 2020. Lastly, ensure that the CPT code billed matches the telemedicine service documented, and that the CPT code is an allowed code per your state telemedicine policy. If you have questions, we recommend that you refer to insurance-specific billing guidelines.

Helpful Resources

As mentioned above, I recommend you refer to your local health authority guidelines, the American Optometric Association guidelines, as well as current regulatory guidelines and notices. Other helpful resources include:

As we navigate these changes together, and with our patients, it is important to realize that policies and coding information are changing frequently. I urge you to stay up to date and to monitor CMS announcements regularly. At Eyefinity, we will continue to do everything we can to keep our customers in the know and our products in alignment with the evolving regulations.

For specific questions about using telemedicine functionality in Eyefinity EHR, current users can contact the Eyefinity Customer Care team at TelehealthSupport@Eyefinity.com.

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