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  • Interprofessional Internet Consultations - CodingIntel
    CMS recognizes and pays for six codes for interprofessional consults codes 99446–99449, 99451, 99452 These codes were updated in 2023 Codes 99446, 99447, 99448, 99449 and 99451 may now be performed by physicians and other qualified health care professionals
  • Molina Healthcare General Billing and Coding Policy
    Current Procedural Technology (CPT) guidance published by the American Medical Association (AMA) ICD-10 guidance published by the National Center for Health Statistics State-specific claims reimbursement guidance Other coding guidelines published by industry-recognized resources
  • CPT® Code 99448 - Interprofessional Telephone Internet . . . - AAPC
    A consulting physician or other qualified healthcare professional performs a 21– to 30–minute consult via telephone, internet, or electronic health record (EHR) and provides a verbal and written report to the requesting physician qualified healthcare professional
  • How to Use CPT Code 99448 with Modifiers: Telemedicine . . .
    This article explores CPT code 99448 and how modifiers like 25, 95, and GQ clarify billing for telemedicine and interprofessional consults Discover the power of AI in medical billing compliance and optimize your revenue cycle with accurate coding practices
  • Coding Reimbursement Guidelines for Interprofessional Consultation . . .
    99448: 21–30 minutes of medical consultative discussion and review; and 99449: 31 minutes or more of medical consultative discussion and review In January 2019, the Centers for Medicare Medicaid Services (CMS) unbundled CPT codes 99446–99449, and the need for a specialist appointment was removed
  • 2 new codes developed for interprofessional consultation
    For codes 99446-99449, written documentation can include date of call; patient name, insurance information and date of birth; brief statement of the problem; pertinent physical exam findings reported by the requesting treating physician QHP; labs X-ray findings; differential diagnosis (if applicable) and focused recommendations
  • Molina Clinical Policies - Molina Healthcare
    Molina Clinical Policies (MCPs) are used by Molina’s Medical Directors and internal reviewers to make Medical Necessity determinations and are available to providers for review Note: These MCPs do not constitute plan authorization, nor are they an explanation of benefits
  • Molina Clinical Policy Category III CPT Codes: Policy No. 321
    The Member's benefit plan determines coverage – each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits Members and their Providers will need to consult the Member's benefit plan to determine if there are any exclusion(s) or other benefit
  • Provider Telehealth Resource Guide - Molina Healthcare
    All Telemedicine Telehealth services must be medically necessary and documented and in the applicable medical record in order to be reimbursable Documentation may be requested to support medical necessity reviews *Efective November 15, 2020, the permanent version Telehealth rule, 5160-1-18, will replace the emergency version II





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