Wednesday, January 15, 2020

New Online Digital E/M Service Codes for 2020 #PACPearls

PAC Pearls from the Women’s Dermatologic Society

New Online Digital Evaluation and Management (E/M) Services Codes went into effect on January 1, 2020. Please keep in mind that there are many provisions, which take up a full page in the 2020 CPT book, that have to be met in order to use the codes. Below is a summary of the main points.

 2020 Online Digital E/M Service Codes to Note

  • 99421: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes 
  • 99422: 11-20 minutes 
  • 99423: 21 or more minutes

Patient Initiated Codes

These codes are for established patients only, and must be patient initiated. The patient has to initiate it through a HIPAA compliant platform or secure email. It cannot deal with administrative issues, but rather must have some patient complaint that must not be related to any complaint dealt with by an office visit within the last 7 days. 

If the complaint deals with a surgical procedure, and they are in the surgical global period, then you CANNOT bill these. The codes themselves have a “built-in” global period, meaning if there is an online “conversation” with the patient over a 7 day period, you only report one code- but you DO add up the times. And if you actually see the patient within 7 days, you can add the time spent into your E/M calculation (this may be more relevant in 2021 with new E/M paradigm, but that’s for another pearl).

What about Valuations?

2020 Physician Fee Schedule
CPT Code
2020 Payment
5-10 min
11-20 min
21+ min

The Women’s Dermatologic Society (WDS) Practice Advisory Committee supports WDS members at any stage of their career looking to manage or start their own practice by offering resources on navigating the practice environment.

Tuesday, December 31, 2019

Advances in Dermatology: A Year in Review

What a year 2019 has been for the field of dermatology! Researchers and dermatologists have been working hard to propel the specialty forward, and the hard work has paid off. From discoveries in basic science, to new drugs and new indications for old drugs, there is a lot to review.

>> Read the Full Editorial
  • New Clinical Guidelines
  • New in Psoriasis Treatment
  • New in Atopic Dermatitis
  • New in Hair Loss
  • New in Disorders of Pigmentation
  • New in Acne
  • New in Cosmetic Dermatology
  • New in Cutaneous Oncology

              Wednesday, December 18, 2019

              Career Corner: Post Residency Dermatology Opportunities

              The WDS Young Physicians Committee has put together resources to provide more information on Post-Residency Dermatology opportunities including Traditional Post-Residency Fellowships, Non-Traditional Fellowships, and more.

              >> Read the Full Article

              • Micrographic Surgery & Dermatologic Oncology (Mohs) Fellowships
              • Dermatopathology Fellowships
              • Pediatric Dermatology Fellowships
              • Cosmetic Dermatology Fellowships
              • Complex Medical Dermatology Fellowship
              • Contact Dermatitis Fellowship
              • Teledermatology Fellowship
              • Dermatology/Rheumatology Fellowship
              • Research Fellowships
              • Cutaneous Oncology Fellowship
              • Clinician Educator Fellowship

              Young Physician Spotlight: Monica Boen, MD

              Young Physician SpotlightMonica Boen, MD is a board-certified Dermatologist in San Diego, California. She completed her medical degree at Northwestern University’s Feinberg School of Medicine. During medical school, Dr. Boen pursued her interest in global health and did medical rotations in South Africa and France.

              For dermatology training, Dr. Boen attended the University of Illinois at Chicago, where she served as chief resident. Further cosmetic surgery training included completion of a fellowship through the American Society for Dermatologic Surgery.

              >> Read the Full Interview

              Monday, November 18, 2019

              Difficult Conversations with Patients #PACPearls

              PAC Pearls from the Women’s Dermatologic Society

              Follow these tips from the WDS Practice Advisory Committee (PAC) for all stages of having difficult conversations with patients.

              Before the Conversation

              Successfully addressing an unhappy or concerned patient requires training and preparation. Approach difficult conversations with a customer service mindset using a method called BLAST – Believe, Listen, Apologize, Satisfy, Thank.

              Detailed by Albert Barneto and further expounded upon for clinicians by Dr. Howard K. Steinman, the BLAST method is a standardized customer based conflict resolution method. By incorporating the BLAST method into staff training, you will be better prepared to have difficult conversations with patients.

              During the Conversation

              Believe: Believe in the genuineness of the patient's concern and the emotion attached to it.

              Listen: Maintain eye contact and actively listen without judgement to determine the patient’s concerns. Avoid escalating the emotions of the situation as you can always pause for 5 seconds or reconvene at a later time.

              Apologize: Empathize and validate the emotions of the patient. Apologize for the patient’s unmet expectations and offer more context to the issue by restating the patient’s own words.

              Satisfy: Offer a resolution to the patient if you are able, but make sure to also address any expectations that you cannot reasonably meet.

              Thank: Thank the patient for expressing their concerns and providing an opportunity to offer assistance.

              After the Conversation

              Patients may not absorb all the information you are telling them particularly if you are delivering bad news. Providing them with appropriate contact information will allow them to ask you, or your staff, questions in their own time.

              Also keep in mind that despite you’re telling them not to, your patients are going to look up their disease or condition on the internet. That being the case, try and give them information, or sources, that you know will be more informative, and less dramatic.

              More Information: Steinman HK. A method for working with displeased patients-blast. J Clin Aesthet Dermatol. 2013;6(3):25–28.

              The Women’s Dermatologic Society (WDS) Practice Advisory Committee supports WDS members at any stage of their career looking to manage or start their own practice by offering resources on navigating the practice environment.