Blue Shield Scenario 1
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Established patient visit with a provider who uses an audio-video or audio-only telecommunications system for COVID-19 or non-COVID-19 related care.
Step 1. Use appropriate Office Visit E/M code: 99211-99215
Step 2. Use place of service that would have been reported had the service been furnished in person: 02 or 10 (when patient is at home)
Step 3. Use modifier: 95 eff. 5.1.20 (updated May 7, 2020)
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Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.
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Blue Shield Scenario 2
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Established patient visit with a provider who uses an audio-video or audio-only telecommunications system for evaluating need for COVID-19 testing.
Step 1. Use appropriate Office Visit E/M code: 99211-99215
Step 2. Use place of service that would have been reported had the service been furnished in person: 02 or 10 (when patient is at home)
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Step 3. Use modifier: 95 eff. 5.1.20 (updated May 7, 2020)
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Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.
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Blue Shield Scenario 3
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Established patient with COVID-19 diagnosis visits with a provider who uses an audio-video or audio-only telecommunications system.
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Step 1. Use appropriate Office Visit E/M code: 99211-99215
Step 2. Use place of service that would have been reported had the service been furnished in person: 02 or 10 (when patient is at home)
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Step 3. Use modifier: 95 eff. 5.1.20 (updated May 7, 2020)
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Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.
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Blue Shield Scenario 4
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New patient visit with a provider who uses an audio-video or audio-only telecommunications system COVID-19 or non-COVID-19 related care.
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Step 1. Use appropriate Office Visit E/M code: 99202-99205
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Step 2. Use place of service that would have been reported had the service been furnished in person: 02 or 10 (when patient is at home)
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Step 3. Use modifier: 95 eff. 5.1.20 (updated May 7, 2020)
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Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.
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Blue Shield Scenario 5
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New patient visit with provider who uses and audio-video or audio-only telecommunications system for evaluating need for COVID-19 testing.
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Step 1. Use appropriate Office Visit E/M code: 99202-99205
Step 2. Use place of service that would have been reported had the service been furnished in person: 02 or 10 (when patient is at home)
Step 3. Use modifier: 95 eff. 5.1.20 (updated May 7, 2020)
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Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.
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Blue Shield E-Visit Scenario 1
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Electronic Visit (e-visit) Communication between an established patient through an online patient portal for COVID-19 or non-COVID-19 related care.
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Step 1. Use appropriate Office Visit E/M code: 99421-99425
Step 2. Use place of service that would have been reported had the service been furnished in person: 02 or 10 (when patient is at home)
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Step 3. No modifier.
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Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.
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Blue Shield Virtual Check In Scenario 1
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Virtual Check-In. A brief check-in with the provider using audio-only with established patient for COVID-19 or non-COVID-19 related care.
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Step 1. Use appropriate HCPCS code: G2012
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Step 2. Use place of service: 02 or 10 (when patient is at home)
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Step 3. No modifier.
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Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.
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Blue Shield Virtual Check In Scenario 2
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Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment.
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Step 1. Use appropriate HCPCS code: G2010
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Step 2. Use place of service: 02 or 10 (when patient is at home)
Step 3. No modifier.
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Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.
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Blue Shield Telephone Assessment
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Telephone assessment and management service by a physician or other qualified healthcare professional to establish a patient, parent or guardian not related to E/M service provided within the past seven days or leading to an E/M service or procedure within 24 hours or the soonest available appointment.
Step 1. Use appropriate Office Visit E/M code: 99441- 99443
Step 2. Use place of service: 02 or 10 (when patient is at home)
Step 3. No Modifier
Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.