Diabetes and COVID-19

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Using Telemedicine in the time of novel coronavirus

  • 1.  Using Telemedicine in the time of novel coronavirus

    Posted 03-24-2020 21:29
    How are you using telemedicine in this new post-coronavirus time? We shifted from the occasional use to 50% last week to 90% the past two days and in the future. How are you all managing? What advice do you have for other practices?

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    Mark Harmel, MPH/CDCES (CDE)
    Clinical Research Coordinator
    USC Westside Center for Diabetes
    Los Angeles
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  • 2.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-25-2020 12:20

    When You advice on telemedicine, tell the patient about diabetes web site and info available there; ask them to fax Sugar logs and advice on COVID-19 at thw same time

     

    Subhashini Yaturu, MD

    Staff Physician, Dorn VA Medical Center/

    Professor of Medicine, USC School of Medicine

    Columbia, SC

    803-776-4000x6092

     






  • 3.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-25-2020 12:37

    Hello everyone,

    Stay healthy.

    Using phone visits, mostly.

    Some brave patients want to come to the office so, they come.

    Our CDE group in our region,  is here for the duration, or until someone tells us to pack it up and go home.

    Pumps, CGMs, monitors mostly coming from the cloud.

    So many people waiting for pump/cgm trainings.

     

     

    Most Sincerely & take care.

     

    Maria/Tina

     

    Maria C Matas-Chamberlain, MS, RN, CDE

    Kaiser Permanente MAS

    Gaithersburg Medical Center

    655 Watkins Mill Road

    Diabetes Services

    5th Floor

    Adult Medicine

    Area 500

    Gaithersburg, Maryland 20879

    maria.c.matas-chamberlain@kp.org

    240-632-4091 Direct

     

     

     

     

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  • 4.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-26-2020 13:31
    It might be a good idea to reach out to the sales reps as they are also working remotely.  The industry representatives
    may be willing to do remote teaching to those needed to learn how to use monitors, pumps, cgm's, etc.  Just a thought...……...

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    Paula Jimenez BSN
    ILLINOIS DEPARTMENT PUBLIC
    SPRINGFIELD IL
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  • 5.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-25-2020 12:47
    I am curious if anyone started using inpatient telemedicine for inpatient diabetes management?


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    Mihail Zilbermint, MD
    Bethesda MD
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  • 6.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-25-2020 14:53
    How do you bill these patients?
    I understand Telemedicine is not billable for diabetes education.


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    Shesha Desai
    RWJ UNIV HOSPITAL HAM
    Hamilton NJ
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  • 7.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-26-2020 12:31
    This might help:

     

    https://www.eatrightpro.org/news-center/member-updates/coronavirus-updates/during-covid19-emergency-cms-gives-green-light-to-mnt-via-telehealth-for-medicare-beneficiaries



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    Cristin Bruns
    OKLAHOMA HEART INSTITUTE
    TULSA OK
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  • 8.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-27-2020 13:10
    ​Hi Boris and group,
        Let me see what we can do at Medtronic to get that rule suspended.  As you know it comes from payers including CMS but I can try to get our team to work on it.
    Bob

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    Robert Vigersky MD,
    WASHINGTON DC
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  • 9.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-25-2020 18:42
    We are basically doing phone consults right now to help with urgent needs. We would like to start officially doing telehealth but are unsure how to bill.  It is my understanding that traditionally only our RDs can charge for telehealth using MNT codes. It would be great if that was opened up to DSME codes as well. Has anyone found any information on it being opened up to DSME? For those billing for MNT, are they different billing codes than our traditional or must we enter coding differently? Thank you!​

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    Danette Anderson
    VERDE VALLEY MEDICAL CTR
    COTTONWOOD AZ
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  • 10.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-26-2020 14:18
    We are able to bill for MNT using telehealth but as a RN-CDE I am told I cannot bill for DSME through telehealth.  I agree that it is important that we liberalize these rules to allow DSME codes. Can the ADA help with this? Any insights would be appreciated, thank you

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    Amy Katz
    BOZEMAN MT
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  • 11.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-26-2020 22:02
    diaTribe published an article I wrote for patients on the new telemedicine reality that includes nuts and bolts tips on how to upload devices from home and how the connections can be made. 

    Let me know if you have tips for improvements.

    Re: Using Telemedicine in the time of novel coronavirus  

    Mark Harmel, MPH, CDCES (CDE)
    Clinical Research Coordinator at the USC Westside Center for Diabetes
    310-546-6509






  • 12.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-27-2020 12:17
    I am an RD, CDE (CDCES technically now), and we are able to bill MNT and DSMT through telehealth. There is a modifier code available in our EMR (EPIC) called GT that bills as a virtual visit. I have heard that RNs are not yet approved to bill for telehealth, however. AADE has been doing webinars for telehealth. I have the slides from the recent webinar if you are interested. I cannot attach to this post, but I can email them to you if you'd like.

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    Sherri Hall, MS, RD, CDCES
    Certified Diabetes Care & Education Specialist
    CHI Francsican
    Tacoma, WA
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  • 13.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 04-08-2020 13:08
    Yes, I would be interested in the slides.​

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    Shesha Desai
    RWJ UNIV HOSPITAL HAM
    Hamilton NJ
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  • 14.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-27-2020 13:16
    Hello,
    It is exciting that RDNs now temporarily have options for delivering MNT services via telehealth.  I work in a hospital outpatient diabetes setting, can I still bill under code 02 for telehealth?

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    Pauline p Chau CDE, RD
    BELMONT CA
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  • 15.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 04-02-2020 18:58
    Did you ever find an answer to your question about billing when hospital based? I am trying to find out that info also for our RD CDE's.

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    Cristin Bruns
    OKLAHOMA HEART INSTITUTE
    TULSA OK
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  • 16.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 04-08-2020 13:06
    No, still looking for an answer.
    Also if I- with a Pharmacist background and with BC-ADM is eligible to bill​

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    Shesha Desai
    RWJ UNIV HOSPITAL HAM
    Hamilton NJ
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  • 17.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-26-2020 13:37
    Edited by Brea di Dato 03-26-2020 13:38
    Hello

    I work for a psychiatry practice and we are currently fully remote for all visits.

    All restrictions for payment of televisits have been lifted but each insurance company has made their individual rules regarding the matter. So check with the insurance company. Payment for video vs telephone are different. Video is preferred.

    We use our EHR (eclinical works) for primary contact, it has video built in. If that fails we use doxy.me as back up (free and hippa compliant, no need for patient to have a profile or account just send them your url to join you)

    You must have consent for video visits, so make sure to consent them if not already included in your practice.
    You must have a license in the state the patient is attending the visit from (despite announcements that providers will be allowed to practice across state lines the professional licensing boards have not agreed, check with you board in the state to ensure this is allowed)

    I recommend checking facebook for pages telemedicine groups in your speciality.

    There is also a facebook page for COVID-19 USA physician/app group facebook page where all medical specialities discuss covid related practice challenges. There is a long discussion thread on getting telemedicine working in their practices and payment requirements.

    Hope this helps.

    Brea

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    Brea Di Dato
    Nurse Practitioner & Type 1 Diabetic
    MSN APRN FNP-C PMHNP-BC
    Well Coast Psychiatric
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  • 18.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-27-2020 14:32
    We have moved to 100% remote visits for established patients and are also doing remote care for some new patients (case-specific). A how-to clinician's guide for diabetes telehealth that I co-authored was just published and made open-access: https://www.liebertpub.com/doi/pdf/10.1089/dia.2020.0042. This may be helpful for many. Info about reimbursement and HIPAA has changed currently with COVID19 which allows more innovation and flexibility, but it's hard to keep up with the changes. We plan to publish a letter about recent changes and link it to this article ASAP so people have additional guidance. In the meantime, the ATA's website has helpful updates about new policies re: reimbursement and use of technology: https://www.americantelemed.org/.

    Stephanie Crossen, MD, MPH
    Pediatric Endocrinology & Diabetes
    University of California, Davis

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    Stephanie Crossen
    SACRAMENTO CA
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  • 19.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-29-2020 22:15
    Thanks Stephanie! Great article!
    Evan Los
    Pediatric Endocrinology
    East TN State University

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    Evan Los DMSC
    408 N STATE OF FRANKLIN RD
    JOHNSON CITY TN
    423-431-4946
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  • 20.  RE: Using Telemedicine in the time of novel coronavirus

    Posted 03-30-2020 13:24
    Outpatient: almost 100% phone or video calls. Video rvu reimbursement is much higher than phone calls. We are using Epic apps Haiku (iphone) or Canto (ipad)- most providers are working from home.

    Inpatient: almost exclusively virtual visits with review of glucose levels and remote adjustments in insulin regiments.

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    Marc a Vengrove DO, FACP
    LEHIGH VALLEY HEALTH NTWRK
    ALLENTOWN PA
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