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Practicing Medicine Providing Care COVID-19 COVID-19 FAQ

COVID-19 FAQ

Answers to frequently asked questions during the COVID-19 pandemic

Updated April 24, 2020

Personal protective equipment (PPE)

Q: We are unable to find masks, gowns and sanitizer. What can the AOA do to help us secure these products?

To assist the osteopathic community during the COVID-19 pandemic, the AOA has reached an exclusive agreement with NEXVOO to provide AOA members with a special discount on FDA-certified KN95 and 3-ply surgical masks. Reduced pricing is available for purchase of KN95 masks in quantities of 100 or 1,000 and for 3-ply masks in quantities of 1,000. Orders in these quantities may also be bundled for greater savings. Learn more.

We’re also encouraging physicians to tell their members of Congress to act now to ensure access for physicians to adequate PPE, and to share how COVID-19 is impacting their ability to care for their patients via email and/or Twitter. In addition, please use and share these tools to keep track of COVID-19 federal and state legislative activity.

OMT/OMM

Q: Can OMT/OMM be used as a treatment for patients with COVID-19 or suspected COVID-19?

The AOA partnered with the American Academy of Osteopathy (AAO) to offer an online learning activity to help you review applicable OMM techniques for optimizing pulmonary function in COVID-19 or suspected  COVID-19 patients.  The e-Learning module, titled “Osteopathic Manipulative Medicine (OMM) Techniques Addressing Respiratory Symptoms of COVID-19” will provide a refresher in applicable OMM techniques. Free for all members and non-members, the patient-centered CME will offer 1.0 AOA 1-B credit or 1.0 AMA PRA Category 1 Credits™.  Learn more and enroll today.

Q: Does insurance reimburse for the house visit and OMM/OMT, and what are the codes?

Phone calls and telemedicine visit guidelines have been lifted for services related to COVID-19 or checking on patients. OMT being a manual modality would not be something that can be provided through the audio-visual exchange.

As far as insurers reimbursing for house calls, it varies by each insurer and you would need to check your contract and fee schedule.

Per the AOA Physician Services team, house call codes (99341-99345 for new patients and 99347-99350 for established patients) are found under the Home Services subsection in the Evaluation and Management section. CPT® house call codes are like office visit codes, but with two major differences: The typical face-to-face time is longer with house calls. They may only be billed when services are provided in the beneficiary’s private residence (POS 12). To bill these codes, physicians must be physically present in the beneficiary’s home.

In the case of house calls, physicians need to document that the home visit was medically necessary. In other words, you must present a medical – rather than practical – reason for visiting a patient outside the office. Here are a few other considerations to keep in mind when you bill for a house call:

  • Providers need to document if the home visit is based upon a one-time, ongoing or permanent need.
  • Documentation should prove that the patient is not physically capable of traveling to the office. You may base this assessment on physical or mental issues but not on financial or personal issues.
  • Home services can’t be provided for the physician’s convenience.
  • Patients receiving care under Medicare’s home health benefit must be confined to the home. However patients don’t need to be homebound for physicians to provide services billed under CPT codes 99341 through 99350.

The Office of Inspector General (OIG) and many CMS contractors regularly audit home services billed to Medicare. Make sure to provide appropriate documentation showing that the house call was medically necessary.

Please note the CMS recommendations for non-emergent procedures and remember that the OMT codes fall within the surgery section of the CPT book.

Licensing

Q: I’m a retired physician. I heard we’re being asked to rejoin the workforce. How do I activate my license again to start practicing?

Many states have eased licensing requirements to allow more physicians to help meet the growing healthcare needs of the pandemic. AOA members can send their AOA Profile to all state medical boards at no cost; and non-members only pay a nominal fee. This benefit can enable you to serve in areas of need more quickly through expedited credentialing. Get started at AOAprofiles.org.

Q: The cost of sending profiles is too high for non-members. Is the AOA doing anything to help with the cost when extra physicians are needed during this time?

The AOA is helping physicians, both active and retired, serve in an area of need during the COVID-19 pandemic through expedited credentialing. AOA members can send their AOA Profile to all state medical boards at no cost. For non-members, we are temporarily reducing the per profile cost to $5 per state board. Learn more.

Telemedicine/telehealth

Q: I have never used remote patient care. Do you have any resources/ websites/ methods to help me with telemedicine?

Our Telemedicine Resource Center provides a wealth of resources for physicians looking to incorporate telemedicine into their practices including:

  • On demand webinar: Billing & coding under new telehealth rules
  • On demand webinar: New rules for telehealth documentation & technology
  • On demand webinar: HIPAA & telemedicine
  • On demand webinar: Practicing medicine successfully from a distance
  • Current telehealth regulations in your state
  • Telehealth Guide

Additionally, the HHS Office for Civil Rights (OCR) is allowing access to a variety of telehealth platforms, and relaxing HIPAA enforcement of communication tools for virtual visits. Physicians may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype. Physicians should not use Facebook Live, Twitch, TikTok or other public facing communication services.

States can cover telehealth using various methods of communication such as telephonic, video technology commonly available on smartphones and other devices. No federal approval is needed for state Medicaid programs to reimburse providers for telehealth services in the same manner or at the same rate that states pay for face-to-face services. For more information on this announcement, read the HHS Fact Sheet.

In addition, the following products can assist in the short term with monitoring or live video consult of patients during the coronavirus outbreak:

Remote Monitoring of Patients

AOA Member Value Partner Ceras Health is a remote patient monitoring platform can be set up for AOA members with no implementation fee. Patients who want to be tested for the virus or those who have already tested positive for the virus download the Ceras app and enter their vitals three times a day. Those readings are monitored by a Ceras RN. If the readings raise an alert, the Ceras RN will notify the patient and you for follow up. Consult with Ceras on your state reimbursement.

HIPAA-Compliant Video Platform

Bluestream Health is offering AOA members free access to HIPAA-compliant video sessions with patients during the COVID-19 crisis. Go to Bluestream, enter your email address and full name, and Bluestream will create a platform for you to send a secure invite to your patient via text or email. The patient clicks on the link and a HIPAA-compliant video session with you begins. Details from the visit can be downloaded into a HIPAA-compliant repository.

Training for students and resident physicians

Q: How will closures impact my residency and training?

We understand that training cycles have been disrupted. While we’ll defer to the ACGME and the AOA PTRC for how they will accommodate, manage and address gaps in training and other GME-related challenges, we’re ready to assist residency graduates with expedited board certification once meeting the training requirements. In addition, the Bureau of Osteopathic Specialists has announced policy updates, including a one-year extension of board eligibility for candidates seeking initial certification in 2020.

Q: What are the next steps for board certification, now that my exam has been cancelled?

Our Certifying Board Services team continues regular communication with our Specialty Board members and physicians on both initial exams and recertification, including informing candidates and diplomates that testing centers are closed. Instructions for rescheduling exams will be shared soon.

We understand that training cycles have been disrupted. While we’ll defer to the ACGME and the AOA PTRC for how they will accommodate, manage and address gaps in training and other GME-related challenges, we’re ready to assist residency graduates with expedited board certification once meeting the training requirements. In addition, the Bureau of Osteopathic Specialists has announced policy updates, including a one-year extension of board eligibility for candidates seeking initial certification in 2020.

While we don’t yet know the full impact of closures and cancellations related to COVID-19, we can tell you that we are investigating ways to expedite certification, ease the financial burden to candidates and modify our certification and OCC requirements.

Once all training requirements are met, the AOA’s specialty boards will be ready to assist you with:

  • Expedited board certification;
  • Identification of resources to fund application fees for those residents experiencing loss of income and financial hardship as a result of the virus; and
  • Case-by-case review for accelerated board certification timelines when completion of on-time training is negatively impacted by situations beyond individuals’ control.

In addition, the AOA is expediting evaluation and launch of technological innovations enhancing access, convenience and ease of exam administration.

Finally, if you are registered for an early entry initial certification (EEIC) exam scheduled to occur in the spring of 2020 and an extended need for social distancing results in that exam being rescheduled to the summer or fall of 2020, the EEIC application fee will be applied to the future initial certification exam with no additional administrative costs.  Further, despite the fact that the candidate may have graduated, we will honor their resident eligibility status for the EEIC pathway.

For questions or concerns about AOA Board Certification, please contact Chaunessie Baggett at cbaggett@osteopathic.org or 312-202-8017.

CME

Q: Is the AOA deferring CME for a period of time due to coronavirus ?

Check the AOA event status regularly for information and updates on meeting, conference and board exam closures. The AOA continues to monitor the COVID-19 pandemic and due public safety some meetings and exams are being evaluated on a case by case basis in accordance with recommendations from the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and state and local health agencies.

In addition, the AOA offers at-home and on-demand CME options for all members and nonmembers offered by AOA-approved CME sponsors through the AOA Online Learning Center.

Q: I cannot travel, how will I meet my live requirements by my licensure renewal (CME Requirements) deadline?

To address the concern of travel restrictions, the AOA has compiled a central resource for online 1A courses and virtual conferences, in place of live events.  These activities meet the criteria for 1A credit and there is no limit for 1A credit.

For LIVE 1A Events, visit the AOA CME Search Page or the AOA Events Page.

For Online 1A courses:

Click here to see additional activities approved for AOA Category 1A and 1B.

Q: Due to all the cancellations of conferences and meetings, how can I still receive credits?

The AOA offers at-home and on-demand CME options for all members and nonmembers offered by AOA-approved CME sponsors through the AOA Online Learning Center.

Q: How are we going to complete GME and Predoctoral education requirements?

We understand that training cycles have been disrupted. While we’ll defer to the ACGME and the AOA PTRC for how they will accommodate, manage and address gaps in training and other GME-related challenges, we’re ready to assist residency graduates with expedited board certification once meeting the training requirements. We’re investigating ways to expedite certification, ease the financial burden to candidates and modify our certification and OCC requirements.

General COVID-19 medical product questions

Q: What products are impacted?

Personal Protective Equipment (PPE) because of the manufacturing in Hubei Province, China

  • Masks-N95, Surgical, and Procedure
  • Gowns- Isolation, Surgical, and Coveralls
  • Gloves
  • Traditional Wound Care

Q: What is taking place in China?

  • Prior to the Chinese Lunar New Year: Production was ramped up
  • During the Chinese Lunar New Year: COVID-19 halted production
  • Most manufacturing facilities have resumed productions
    • Reports are that factories are running at 80%
    • There will be delays as global transportation restarts from China

Q: What is taking place in other manufacturer countries?

  • Some countries, like Malaysia, are announcing government mandated closures that will impact their economies, including locally based PPE manufacturers
  • These actions, designed to limit the spread within these regions, will put additional stress on the supply chain and product availability

Q: What is happening with the higher utilization products?

  • Products are being allocated based on past utilization and product availability
  • Non-medical grade N95 masks are likely going to get approval for use in medical facilities. This will expand domestic manufacturing capacity.
  • Medications: most have a 3-4 month supply stored domestically

Q: What should I be doing?

  • Work closely with your distributors and key suppliers to get your allocated products.
  • Keep backorders open
  • Be aware of fraudulent suppliers taking advantage of the situation by selling non-regulated products
  • Conserve all your products
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