Surge in Telehealth

Virtual visits in the U.S. are expected to exceed 1 billion in 2020 largely because of COVID-19, according to recent Forrester report. For its Predictions in 2020 virtual care report, Forrester examined the state of telehealth in the U.S. and what member demand will look like by the end of the year. One insight shared was that COVID-19-related care will account for 900 million virtual visits in 2020, while general care and the flu will contribute 200 million virtual visits. Mental health visits will account for 80 million telehealth visits.

Education and Communication

Prior to the coronavirus pandemic, only 24% of U.S. healthcare organizations had an existing virtual care program as of January 2020. With a low telehealth adoption rate prior to COVID-19, providers were not familiar with the information needed in the patient record to properly code telemedicine. CMS has done a good job of updating their list of telehealth services, but it’s a long one!

HIM and coding teams had to react quickly to this new challenge. For example, KIWI-TEK’s Coding Operations Team immediately implemented comprehensive telehealth training and education at the onset of these new code sets. We were then able to offer our expertise on telemedicine coding to clients that were unprepared.

Physician Documentation and Reimbursement

While getting their coding teams up to date on telehealth education, HIM professionals also led the effort to educate clinicians on the documentation requirements. Consents, reminders and communications for telehealth were offered as guidance from AHIMA, including:

• Educate staff that virtual care/telehealth visits are more than a conversation. They are documented episodes of care that require the same clinical documentation processes as seeing a patient in a traditional care setting.
• As physicians and advanced practice clinicians take care of patients, the quality of clinical documentation is of utmost importance. The expectation is that they will continue with the high standards of documentation, which they’ve always had.
• As regulations remain fluid around these new virtual care settings, documentation will be even more important and will help us post-crisis to ensure accurate billing, coding and syndromic reporting.

Easing the documentation burden is essential to reduce clinician burnout, now more than ever with COVID-19.

While physician reimbursement for telehealth is still considered murky, there are several sources including a practical Q&A from Medical Economics that addresses specific reimbursement questions posed by physicians. MGMA also offers information for navigating telehealth billing requirements. Understanding these terms is critical for both providers and originating sites to ensure eligibility, service delivery and proper reimbursement.

The HIM community is learning and evolving with telehealth, along with the rest of the world. KIWI-TEK is proud of our team and our peers for meeting the COVID-19 challenges of new documentation and coding guidelines. If you’re looking for help with telemedicine coding, please send us a note here.

Stay tuned for next week’s post on another HIM COVID-19 challenge—changes in patient type and volume, and how our industry responded.

You can also check out our previous post on a remote HIM workforce.