AETNA

Aetna E-Visit Scenario 1

Electronic Visit (e-visit) Communication between an established patient through an online patient portal for COVID-19 or non-COVID-19 related care.

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

Step 3. No Modifier.

Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.

Aetna Virtual Check In Scenario 1

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.

 

Step 1. Use appropriate HCPCS code: G2012

 

Step 2. Use place of service: 02

 

 

Step 3. No Modifier

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

Aetna Virtual Check In Scenario 2

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.

Step 1. Use appropriate HCPCS code: G2010

 

Step 2. Use place of service: 02

 

Step 3. No Modifier

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

 

ANTHEM

Anthem E-Visit Scenario 1

Electronic Visit (e-visit) Communication between an established patient through an online patient portal for COVID-19 or non-COVID-19 related care.

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

 

Step 3. No Modifier.

Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.

Anthem Virtual Check In Scenario 1

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.

Step 1. Use appropriate HCPCS code: G2012

Step 2. Use place of service: 02

Step 3. No Modifier.

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

Anthem Virtual Check In Scenario 2

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.

Step 1. Use appropriate HCPCS code: No information

 

Step 2. Use place of service: No information

 

Step 3. Modifier: No information

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

 

BLUE SHIELD

Blue Shield E-Visit Scenario 1

Electronic Visit (e-visit) Communication between an established patient through an online patient portal for COVID-19 or non-COVID-19 related care.

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

 

Step 3. No modifier.

Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.

Blue Shield Virtual Check In Scenario 1

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.

Step 1. Use appropriate HCPCS code: G2012

Step 2. Use place of service: 02

Step 3. No Modifier

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

Blue Shield Virtual Check In Scenario 2

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.

Step 1. Use appropriate HCPCS code: No information

 

Step 2. Use place of service: No information

 

Step 3. Modifier: No information

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

CIGNA

CIGNA E-Visit Scenario 1

Electronic Visit (e-visit) Communication between an established patient through an online patient portal for COVID-19 or non-COVID-19 related care.

Step 1. Use appropriate Office Visit E/M code: No information

 

Step 2. Use place of service that would have been reported had the service been furnished in person: No information

 

Step 3. Use Modifier: No information

Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.

CIGNA Virtual Check In Scenario 1

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.

Step 1. Use appropriate HCPCS code: G2012

Step 2. Use place of service: 11

Step 3. No Modifier.

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

CIGNA Virtual Check In Scenario 2

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.

Step 1. Use appropriate HCPCS code: No information

 

Step 2. Use place of service: No information

 

Step 3. Modifier: No information

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

CIGNA Virtual Check In Scenario 3

Office consultation for a new or established patient, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making. Counselling and/or coordination of care with other physicians, other qualified health care providers, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self-limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family

 

Step 1. Use appropriate HCPCS code: 99241

 

Step 2. Use place of service: 11

 

Step 3. No Modifier.

Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.

UNITED

United Healthcare E-Visit Scenario 1

Electronic Visit (e-visit) Communication between an established patient through an online patient portal for COVID-19 or non-COVID-19 related care.

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: 11

 

Step 3. Use Modifier: 95

Step 4. Refer to Centers for Disease Control and Prevention (CDC) ICD-10-CM Official Coding Guidelines.

United Healthcare Virtual Check In Scenario 1

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.

Step 1. Use appropriate HCPCS code: G2012

Step 2. Use place of service: 11

Step 3. No Modifier.

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

United Healthcare Virtual Check In Scenario 2

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.

Step 1. Use appropriate HCPCS code: No information

 

Step 2. Use place of service: No information

 

Step 3. Modifier: No information

Step 4. Refer to Centers for Disease Control and Prevention (CDC)  ICD-10-CM Official Coding Guidelines.

PATIENT SCENARIO

Established patient sends message (e-visit) through the online patient portal or some other secure platform (1.e. MyChart).

VISIT

Patient initiates an e-visit on an issue through the provider's online patient portal to a physician, nurse pratitioner or physician assistant.

ELECTRONIC VISIT (E-VISIT) SCENARIO 1:  Communication between an established patient and their provider through an online patient portal for COVID-19 or non-COVID-19 related care. 

VIRTUAL CHECK-IN SCENARIO 1:  A brief check-in with the provider using audio-only with established patient for COVID-19 or non-COVID-19 related care. 

PATIENT SCENARIO

Established patient connects for a brief check-in by audio only (virtual check-in). 

VISIT

  • Patient initiates a phone call with physician, nurse practitioner, or physician assistant.

  • Issue is not related to a medical visit within the previous 7 days and not resulting in a medical visit within the next 24 hours (or soonest appointment available).

VIRTUAL CHECK-IN SCENARIO 2:  A brief check-in with the provider using a recorded video and/or images submitted by established patient for COVID-19 or non-COVID-19 related care. 

PATIENT SCENARIO

Established patient sends picture for evaluation using a brief check-in (virtual check-in). 

VISIT

  • Patient sends a picture for evaluation to a physician, nurse practitioner, or physician assistant.

  • Issue is not related to a medical visit within the previous 7 days and not resulting in a medical visit within the next 24 hours (or soonest appointment available).

CIGNA ONLY

VIRTUAL CHECK-IN SCENARIO 3: Office consultation for a new or established patient, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care providers, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self-limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family

PATIENT SCENARIO

Office consultation for a new or established patient, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making. Counselling and/or coordination of care with other physicians, other qualified health care providers, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self-limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family

VISIT: 

WHAT LANGUAGE GOES HERE

BILLING

CIGNA ONLY

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