Q:
If a telehealth encounter begins with audio-visual but they must convert to audio-only for the rest of the visit, how do you determine which code to use when the payer accepts the phone code 99441-99442 and the video code is 99212-99215?
A:
During the current Public Health Emergency, a variety of telehealth policies have been issued and revised. Currently, the consensus is that if a visit starts out as telehealth and some care is delivered but must convert to audio-only, the service may be reported as a virtual visit. If the attempt at virtual fails before any care begins, audio-only services should be reported. Keep in mind payer policies may vary so you’ll need to verify with your top payers. Once you have some payer information, consider establishing a clinic policy as to when the encounter may be reported as a telehealth service versus reporting an audio-only code.