Read how the reporting of telehealth to the insurance company has changed in 2022, how to use code 01305 correctly and what to look out for.A few years ago, telephone consultations were marginal, now they are the order of the day. But how do you properly report distant care to the insurance company? In a practical webinar, MUDr. Ondřej Sobotka, shared his experience with reporting code 01305.

‍Changesin the reporting of distance care

Prior to covid, telephone consultations were part of the capitation payment. But during the pandemic, telehealth almost replaced office visits and insurance companies introduced code 01300 for it.

After the pandemic subsided, it was expected to be abolished, but patients became accustomed to remote consultations. As a result, some insurers are allowing telecare to be reported under the new code 01305, which replaced the older 01300 code, from 1 April 2022.

You will report the code to the following insurers:

• VZP,
  
• VoZP,
  
• CVHI,
  
• HMOS,
  
• ZPM.
  

From 1 May 2022 also RBP, but the code must be contracted. The code for telecare is not yet offered by the OZP (valid as of 26 September 2022).

TIP: Missed the webinar? Email us at podpora@sestraemmy.cz and we'll send you the full recording for free.

‍Fill incode 01305

The official definition of code 01305 is that it serves: "for an episode of clinical care for a registered patient that is delivered from a PL or PLDD office by a remote means - the patient is not physically present in the office."

"Distance care is entirely in the hands of the physician - it is non-costly on the part of the patients . So it is up to us whether we offer telephone consultations or if we tell the patient that they need to come to the office," said MUDr Ondřej Sobotka, in the webinar.

‍Reportingcode 01305

To report a code for telehealth, you need to meet several conditions. "Typically, it must be a consultation for a change in health status. For example, the patient has become ill or, conversely, has recovered and you are terminating their sick leave. Alternatively, it may be a consultation to monitor the patient's condition, for example, if they have a covid," explained Ondřej Sobotka, MD.

You only display the code for patients who are registered with you and with whom you have been in contact in the last 24 months. This means that you have reported the codes:

• 01021 - initial examination,
  
• 01022 - preventive check-up,
  
• 01201 - diabetes care,
  
• 01204 prediabetic care,
  
• 09532 - examination of a dispensary person,
  
• 02021 - comprehensive PLDD examination of a child under 6 years of age,
  
• 02022 - preventive examination of PLDD of a child under 6 years,
  
• 02031 - comprehensive PLDD examination of a child over 6 years,
  
• 02032 - preventive examination of PLDD of a child over 6 years of age,
  
• 02039 - detection and follow-up of a patient with obesity in the PLDD's office.
  

Importantly, if the patient went to the office only because of illness and you reported code 01543, this does not count as a routine contact in the last two years for purposes of applying code 01305.

Meanwhile, code 01305 is valid until 31 December 2022.

‍Whatelse was covered in the webinar

In the webinar titled "Code 01300 is dead, long live 01305!" participants also learned:

• In what situations they cannot report code 01305,
  
• which codes cannot be combined with code 01305 ,
  
• whether the code for distance care can be entered for pendlers,
  
• how to provide telecare in practice so that the practice is not overloaded.
  

If you were unable to attend the webinar live, email us at podpora@sestraemmy.cz and we will send you a free recording.

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