Coding Corner – Audio-Only Office Visits: Update for 2022 | Rosa Miller Polan, MD and David Holtz, MD

David Holtz, MD

Rosa Miller Polan, MD

We hope this first Coding Corner of 2022 finds you, your family and community healthy at this stage of the pandemic.  

Guidance around telemedicine has been ever changing during the COVID-19 public health emergency. Private insurers have not been as proactive as CMS in continuing to support telemedicine through the ongoing pandemic. The AMA has created a new modifier to allow for the identification of audio-only medical visits. However, we do not yet know how Medicare, Medicaid and other private insurers will reimburse this modifier. Telemedicine is not universally covered, is regulated by the state you practice in, and is dictated by individual insurers. It is the position of the Society of Gynecologic Oncology (SGO) that telemedicine continues to represent a unique opportunity to ensure continuity of care for cancer patients while minimizing risk of exposure to infection.  

Modifier 93 – Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System: 

Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. The totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.  

The official release information can be found on the AMA website. 

ACOG has also posted updates for 2022 on its website, covering topics such as surprise billing, good faith estimates, and the Medicare conversion factor. 

The SGO Coding and Reimbursement Subcommittee invites you to join us for the 2022 Coding Course during the 2022 Annual Meeting on Women’s Cancer. This year’s course will be a hybrid of prerecorded sessions and a live Q&A session to be held on Friday March 18, 2022, in Phoenix, AZ. Topics will include Complex Surgical Coding, Modifiers Demystified, Office E&M Coding, and Telemedicine. The prerecorded sessions will be available for viewing prior to the start of the 2022 hybrid Annual Meeting. We hope you will view them and bring your questions virtually or in person to the live Q&A session! 

David Holtz, MD, is a gynecologic oncologist at Lankenau Hospital in Wynnewood, PA.

Rosa Miller Polan, MD, is a gynecologic oncology fellow at Wayne State University/Barbara Ann Karmanos Cancer Center and the 2022-2024 SGO Coding Fellow.