COVID-19 National AAP Guidelines & Resources on Telehealth Coding & More for Independent Practices

Looking for additional guidance and resources for your practice on clinical management, telemedicine, coding, workflow & waiting room suggestions, personnel management, and more? Check out National AAP’s resources below to help get you through these trying times.

Clinical Guidance

When triaging patients, determine the most appropriate venue for care (e.g., telemedicine visit, office visit, ER). If a patient is at your facility, follow the PPE guidance below.

Use clinical judgment in determining if diagnostic testing is necessary and rule out other potential causes of respiratory illness (e.g. Influenza). Considering the following:

• Local epidemiology of COVID-19
• Clinical course of illness, including presence of symptoms (fever, cough, shortness of breath)
• History of travel to an affected geographic area within 14 days of symptom onset
• Close contact with a laboratory confirmed COVID-19 patient within 14 days of symptom onset.

If you believe diagnostic testing for COVID-19 may be warranted, work with your local and state public health department to test patients for COVID-19 through approved public health laboratories.

Commercial testing should also be coordinated with the local or state public health department. If diagnostic testing specimens are being collected in your office, the appropriate infection control practices, including use of personal protective equipment should be instituted to protect you and your staff. Check the CDC website for the latest guidance on testing.

PPE Guidance

• The CDC recommends health care personnel wear gowns, gloves and eye protection (goggles or face shields, not personal eyeglasses or contacts) when caring for patients with suspected or confirmed cases of COVID-19.
• When entering a patient’s room, health care personnel can use a face mask if an N95 respirator isn’t available.
• N95 or higher-level respirators should be used during aerosol-generating procedures, such as sputum induction or open suctioning of airways. They also should be worn when collecting respiratory specimens, although face masks are acceptable during this procedure if necessary.
• Patients should wear a medical facemask and be placed in a private room with the door closed as soon as possible. If an aerosol-generating procedure is done, an airborne infection isolation room should be used. § More details on the latest PPE guidance can be found in AAP News.

Practice Management

Pediatric practices around the country are facing the challenge of providing care to their patients and families amidst the COVID-19 pandemic.

These practice management resources are geared toward independent practices and offer approaches used by other practicing pediatricians.

Telemedicine and Telephone Care

The CDC recommends that systems are established to prevent patients who can be cared for at home from coming to your facility potentially exposing themselves or others to germs. Telephone systems can be used to deliver messages to callers about when to seek medical care at your facility, when to seek emergency care, and where to go for information about caring for a loved one with COVID-19 at home.

Consider adjusting your hours of operation to include telephone triage and follow-up of patients during a community outbreak. Leverage telemedicine technologies and self-assessment tools, as needed. Information on how to code for telehealth visits and integrate them within your practice can be found here.

Coding

The introduction of 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) in the United States has produced an influx of patients into the health care system. While knowing how to diagnose and treat these patients is vital, being able to appropriately capture this information for data tracking and payment also is important.

Keep in mind, there are no unique codes for evaluating and managing this condition so be sure to clearly document any additional time spent with the family or time spent coordinating any care that is not face-to-face with the patient and/or family.

Visit AAP News for more details and specific codes.

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