KMAP BULLETIN: UPDATED - Wheelchair Seating Assessment Codes Allowed by Telemedicine During COVID-19 Emergency
Date: 04/22/20
KMAP GENERAL BULLETIN 20076 (PDF)
Effective with dates of service on and after March 12, 2020, the following codes will be allowed to be provided via telemedicine (tele-video) by the following approved providers:
- Cerebral Palsy Research Foundation, Wichita, Kansas
- Children’s Mercy Hospital Seating Clinic, Kansas City, Missouri
- KU Medical Center Seating Clinic, Kansas City, Kansas
Providers will be allowed to be reimbursed for the following codes when the originating telemedicine (tele-video) site is in the member’s home (i.e. where the member is receiving services). No payment for the Q3014 code will be made for POS 12 (home) without the physical presence of an enrolled provider.
| Code | Description |
|---|---|
| 97542 | Wheelchair management (e.g., assessment, fitting, training), each 15 minutes |
| 97755 | Assistive technology assessment (e.g. to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes. |
| 97760 | Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(s), lower extremity(s) and/or trunk, each 15 minutes. |
The distant site, where the provider is delivering services, will use the appropriate Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) code with Place of Service code 02 used when providing these services via telemedicine.
Telemedicine services (tele-video) can be made when there is verbal consent received from the patient (to be followed up by written approval) in the medical record. Audio/visual communication can only be utilized if that contact is Health Insurance Portability and Accountability Act (HIPAA) compliant.
These updates do not change or modify the current coverage but allow for an additional delivery method. Allowed provider types and specialties will remain unchanged. Reimbursement will be the same as a face-to-face visit. Existing National Correct Coding Initiative (NCCI) edits/limitations will remain in place and are not waived with this policy.
Per Executive Order No. 20.08: This policy will remain in force until rescinded, until May 1, 2020, or until the statewide State of Disaster Emergency proclaimed on March 12, 2020, relating to COVID-19 expires, whichever is earlier.
Note: The effective date of the policy is March 12, 2020. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented.