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Analysis

Physician Billing for Wound Care Services Rendered via Telehealth

By Revenue Cycle Advisor  
   November 13, 2020

When billing for outpatient telehealth services during the COVID-19 PHE, providers should use the POS code that they would have otherwise used had the service been provided in person.

A version of this article was first published November 13, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

Q: What place of service (POS) codes and modifiers should be reported on physician claims for wound care services performed via telehealth during the novel coronavirus (COVID-19) public health emergency (PHE)?

A: POS codes are two-digit codes that delineate the location in which services were rendered by a provider.

When billing for outpatient telehealth services during the COVID-19 PHE, providers should use the POS code that they would have otherwise used had the service been provided in person.

The following POS codes may be reported on physician and non-physician practitioner claims for wound care services:

  • 11 (physician office): The wound clinic is designated as part of the physician’s office.
  • 19 (outpatient hospital off campus): The wound clinic is hospital based but not on campus.
  • 22 (outpatient hospital on campus): The wound clinic is designated as hospital based.

Physicians billing under Medicare should use modifier -GT (via interactive audio and video telecommunication systems) to indicate that the services were rendered via synchronous telecommunication.

Editor’s note: This question was answered by Gloria Miller, CPC, CPMA, CPPM, vice president of Revenue Cycle Management at Comprehensive Healthcare Solutions Inc. in Tacoma, Washington, during the HCPro webinar “Revitalize ICD-10-CM and CPT Coding for Wound Care.”

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.


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