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Validation of use of billing codes for identifying telemedicine encounters in administrative data

BACKGROUND: Telemedicine is the use of telecommunication technology to remotely provide healthcare services. Evaluation of telemedicine use often relies on administrative data, but the validity of identifying telemedicine encounters in administrative data is not known. The objective of this study wa...

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Autores principales: Yeramosu, Deepika, Kwok, Florence, Kahn, Jeremy M., Ray, Kristin N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892196/
https://www.ncbi.nlm.nih.gov/pubmed/31796039
http://dx.doi.org/10.1186/s12913-019-4753-2
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author Yeramosu, Deepika
Kwok, Florence
Kahn, Jeremy M.
Ray, Kristin N.
author_facet Yeramosu, Deepika
Kwok, Florence
Kahn, Jeremy M.
Ray, Kristin N.
author_sort Yeramosu, Deepika
collection PubMed
description BACKGROUND: Telemedicine is the use of telecommunication technology to remotely provide healthcare services. Evaluation of telemedicine use often relies on administrative data, but the validity of identifying telemedicine encounters in administrative data is not known. The objective of this study was to assess the accuracy of billing codes for identifying telemedicine use. METHODS: In this retrospective study of encounters within a large integrated health system from January 2016 to December 2017, we examined the accuracy of billing codes for identifying live-interactive and store-and-forward telemedicine encounters compared to manual chart review. To further examine external validity, we applied these codes and assessed patient and visit characteristics for identified live-interactive telemedicine encounters and store-and-forward telemedicine encounters in a second data set. RESULTS: In manual review of 390 encounters, 75 encounters were live-interactive telemedicine and 158 were store-and-forward telemedicine. In weighted analysis, the presence of the GT modifier in the absence of the GQ modifier or CPT code 99444 yielded 100% sensitivity and 99.99% specificity for identification of live-interactive telemedicine encounters. The presence of either the GQ modifier or the CPT code 99444 had 100% sensitivity and 100% specificity for identification of store-and-forward telemedicine encounters. Applying these algorithms to a second data set (n = 5,917,555) identified telemedicine encounters with expected patient and visit characteristics. CONCLUSIONS: These findings provide support for use of CPT codes to perform telemedicine research in administrative data, aiding ongoing work to understand the role of non-face-to-face care in optimizing health care delivery.
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spelling pubmed-68921962019-12-11 Validation of use of billing codes for identifying telemedicine encounters in administrative data Yeramosu, Deepika Kwok, Florence Kahn, Jeremy M. Ray, Kristin N. BMC Health Serv Res Research Article BACKGROUND: Telemedicine is the use of telecommunication technology to remotely provide healthcare services. Evaluation of telemedicine use often relies on administrative data, but the validity of identifying telemedicine encounters in administrative data is not known. The objective of this study was to assess the accuracy of billing codes for identifying telemedicine use. METHODS: In this retrospective study of encounters within a large integrated health system from January 2016 to December 2017, we examined the accuracy of billing codes for identifying live-interactive and store-and-forward telemedicine encounters compared to manual chart review. To further examine external validity, we applied these codes and assessed patient and visit characteristics for identified live-interactive telemedicine encounters and store-and-forward telemedicine encounters in a second data set. RESULTS: In manual review of 390 encounters, 75 encounters were live-interactive telemedicine and 158 were store-and-forward telemedicine. In weighted analysis, the presence of the GT modifier in the absence of the GQ modifier or CPT code 99444 yielded 100% sensitivity and 99.99% specificity for identification of live-interactive telemedicine encounters. The presence of either the GQ modifier or the CPT code 99444 had 100% sensitivity and 100% specificity for identification of store-and-forward telemedicine encounters. Applying these algorithms to a second data set (n = 5,917,555) identified telemedicine encounters with expected patient and visit characteristics. CONCLUSIONS: These findings provide support for use of CPT codes to perform telemedicine research in administrative data, aiding ongoing work to understand the role of non-face-to-face care in optimizing health care delivery. BioMed Central 2019-12-03 /pmc/articles/PMC6892196/ /pubmed/31796039 http://dx.doi.org/10.1186/s12913-019-4753-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Yeramosu, Deepika
Kwok, Florence
Kahn, Jeremy M.
Ray, Kristin N.
Validation of use of billing codes for identifying telemedicine encounters in administrative data
title Validation of use of billing codes for identifying telemedicine encounters in administrative data
title_full Validation of use of billing codes for identifying telemedicine encounters in administrative data
title_fullStr Validation of use of billing codes for identifying telemedicine encounters in administrative data
title_full_unstemmed Validation of use of billing codes for identifying telemedicine encounters in administrative data
title_short Validation of use of billing codes for identifying telemedicine encounters in administrative data
title_sort validation of use of billing codes for identifying telemedicine encounters in administrative data
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892196/
https://www.ncbi.nlm.nih.gov/pubmed/31796039
http://dx.doi.org/10.1186/s12913-019-4753-2
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