At the beginning of Covid 19 PHE and during, the insurance payers scrambled around to put together virtual care/telehealth/telemedicine policies. Since then, there were many revisions, so it is of no surprise when Cigna announced that they are adding some of the codes that were on non-permanent virtual list to their Virtual Care Reimbursement Policy.
These Codes are:
However, how can home health services like S9123–Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when CPT codes 99500-99602 can be used), code that is used for coding and billing Private Duty nursing Billing, be used as a virtual code? This code is used for MLTC members that require around the clock nursing care, members that cannot take care of themselves…so how are the services supposed to be done via “virtual care”?
Just my 2 cents….. 🙂
Would you like to read the full Cinga Virtual Care Reimbursement Policy? Click on this link: https://static.cigna.com/assets/chcp/secure/pdf/resourceLibrary/clinReimPolsModifiers/R31_Virtual_Care.pdf
Enjoy this type of content? Follow my blog for more up-to-date medical billing and coding information. #medicalbilling #medicalcoding #reimbursement #telehealth
Latest Blog Posts:
Aetna trauma response reimbursement
The following update applies to Aetna Commercial and Medicare plans. What is changing? In order to get reimbursement for trauma response services Aetna will require an accompanying HCPCS code with the cooresponding Rev codes A qualifying ambulance transport service on the same DOS Rev codes affected: 0681: Trauma Response, Level I0682: Trauma Response, Level II0683:…
UHC: new vascular embolization criteria/policy
Are you a provider that accepts members with the following plans: UHC commercial, Medicare Advantage, and some UHC plans? Then this blog post is for you! What is changing? For any dos 12/1/26 and thereafter UHC will require a prior authorization/ medical necessity review for code 37242 UHC will remove the site of services requirenment…
UHC: GI endoscopy advance notification and SOS update
Are you a provider that accepts UHC commercial or Oxford NY, and CT members? Then this blog post is for you. What is changing? As per UHC- effective on DOS 10/1/26 and there after an advance notice will no longer be required for GI procedures As per UHC- effective on DOS 10/1/26 and thereafter the…
Leave a comment