New Medical Codes

Question: CMS came out with two new G codes this year: G2010 and G2012. How do we use the new codes and what documentation is required?


Answer:

G2010-Remote Evaluation of recorded video and/or images submitted by an established patient, including interpretation with follow-up with the patient within 24 business hours. The request must not originate from a related E/M service provided with in the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.

Example: If an established patient sends you pictures or a video of lesions, you review it and determine it is shingles. Either you can bring them in to be seen or you can explain what it is and if necessary send in a prescription for them. You determine which is medically necessary. If you bring them in to be seen, the time spent on review of the video/picture would be bundled in with the office visit and you could not bill the G0210.


Documentation should include: Patients consent to bill for the service, the photo’s should be stored in the patients file, and documentation of your assessment and plan.


G2012-Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can reports E/M services. Provided to an established patient, not origination from a related E/M service provided with I the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment: 5-10 minutes medical discussion.


Example: A patient was seen in the ED, you do a follow up call or they call you call to determine if they need to be seen. You determine if the patient understands treatment plan and/or you need to make changes to the treatment plan, you determine if it is medically necessary to have the patient seen. If the patient is brought in for an E/M you cannot bill the G2012, it is bundled in with the E/M.


Documentation should include: The patient’s consent to bill, time spent speaking with patient, and your assessment and plan.


Note: Both codes require the beneficiary consent to bill; they will be responsible for a co-insurance. CMS stated in the final rule a verbal consent was acceptable. Providers should document in the patients file that an explanation and acceptance of charges. Each practice may want to have a consent form, but it is not required. Both services can only be utilized for an established patient.


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