Thank you to everyone who was able to participate in our DEF Weekly NP/PA VideoSeries!

The focus of our DEF NP/PA Videoseries on Thursday, May 7, 2020 was to revisit our discussion with our NP and PA leaders in the field of dermatology who have returned or are planning to return to their full-time practices.

TJ Chao shared his recent experiences returning to work in practice in Georgia and Kara Gooding returning to practice in Arizona. Watch our video to see more!

We spoke with Leigh Ann Pansch about her experience with teledermatology and what recent updates there have been with coding patient visits. With the interim final rule released on March 31, 2020, CMS made changes to the way in which providers can document and calculate the E/M for a Telehealth Audio Visual Synchronous Communication visit. According to CMS, for Telehealth visits occurring during the current Public Health Emergency, the level of E/M can be billed by Medical Decision Making (MDM) or Bill by Total Time.

Note that to qualify for a given type of medical decision making, two of the three elements must either be met or exceeded.

Elements for Each Level of Medical Decision Moderate Complexity Multiple Number of Diagnoses and/or Management Options

The number of possible diagnoses and/or the number of management options to consider is based on:

  • The number and types of problems addressed during the encounter
  • The complexity of establishing a diagnosis
  • The management decisions made by the provider

In general, decision-making for a diagnosed problem is easier than decision-making for an identified but undiagnosed problem. The number and type of diagnosed tests performed may be an indicator of the number of possible diagnoses. Problems that are improving or resolving are less complex than those problems that are worsening or failing to change as expected. Another indicator of the complexity of diagnostic or management problems is the need to seek advice from other health care professionals.

Here are some of Leigh Ann’s top Do’s and Don’t’s that she’s learned recently about telehealth visits:


  1. Try it! While it may not be appropriate for every patient need, a wide range of patients benefit from the offering.
  2. While in-office visits are scheduled at a specific time, give a range for telemedicine visits, especially if you’re alternating in-office with telemedicine. This way you won’t get behind.


  1. Decide to write off telemedicine completely once you start working. Alternating in office with telemedicine visits is an excellent way to social distance patients and allows you to be more efficient.
  2. Be so quick to discontinue the offering. Many patients voice appreciation. This platform may allow our patients to be our patients “for life!”

Lastly, we shared a few options for defogging your glasses or shield while wearing a mask. We hope that some of these proved helpful to you! Another one is an easy procedure that only takes a few minutes:

  • Step 1: Wash your hands thoroughly with soap and water.
  • Step 2: Rinse your glasses with water and then lather some soap on the lenses.
  • Step 3: Rinse off your glasses with warm water.
  • Step 4: Dry your glasses using a clean microfiber towel or lens wipe (ie, something that won’t scratch your lenses).

Thank you to everyone who attended our DEF NP/PA Videoseries, but in case you missed it, please check it out below.

We hope to see you again next week. In the meantime, email us at [email protected] for any topics of interest or questions you have. Please continue to check our website at for more information and follow and like us on social media.

You can also visit our website in the Blog section to see this and other resources we have.

Everyone, please stay safe and healthy – thank you again from the DEF!