Table 3 Diagnostic Agreement Between Optimized Billing Code Algorithms and Encounter Review Gold Standard for Specific Encounter Types
From: Validation of use of billing codes for identifying telemedicine encounters in administrative data
Encounter setting | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
Any telemedicine visit (using GT, GQ, or 99444) | ||||
All inpatient & outpatient encounters | 100% (−-) | 99.99% (99.98–99.99%) | 90.8% (86.1–94.0%) | 100% (−-) |
All outpatient encounters (visits, consultations, and online) | 100% (−-) | 99.99% 99.98–100%) | 97.0% (89.3–99.2%) | 100% (−-) |
- Problem-based outpatient visit | 100% (−-) | 99.99% (99.98–100%) | 88.9% (63.3–97.4%) | 100% (−-) |
All inpatient encounters (encounters, consultations, emergency) | 100% (−-) | 99.98% (99.97–99.98%) | 64.6% (52.1–75.4%) | 100% (−-) |
- Inpatient encounter | 100% (−-) | 99.98% (99.97–99.99%) | 55.2% (36.6–72.4%) | 100% (−-) |
- Inpatient consultation | 100% (−-) | 99.9% (99.7–99.97%) | 66.7% (26.8–91.6%) | 100% (−-) |
Live interactive telemedicine (using GT in absence of GQ or 99444) | ||||
All inpatient & outpatient encounters | 100% (−-) | 99.99% (99.98–99.99%) | 84.8% (76.9–90.3%) | 100% (−-) |
All outpatient encounters (visits, consultations, and online) | 100% (−-) | 99.99% (99.98–100%) | 94.3% (79.5–98.6%) | 100% (−-) |
- Problem-based outpatient visit | 100% (−-) | 99.99% (99.98–100%) | 88.9% (63.3–97.4%) | 100% (−-) |
All inpatient encounters (encounters, consultations, emergency) | 100% (−-) | 99.98% (99.97–99.98%) | 64.6% (52.1–75.4%) | 100% (−-) |
- Inpatient encounter | 100% (−-) | 99.98% (99.97–99.99%) | 55.2% (36.6–72.4%) | 100% (−-) |
- Inpatient consultation | 100% (−-) | 99.9% (99.7–99.97%) | 66.7% (26.8–91.6%) | 100% (−-) |
Store and Forward Telemedicine (using GQ or 99444) | ||||
All inpatient & outpatient encounters | 100% (−-) | 100% (100–100%) | 99.7% (98.6–99.9%) | 100% (−-) |
All outpatient encounters (visits, consultations, and online) | 100% (−-) | 100% (100–100%) | 99.7% (98.6–99.9%) | 100% (−-) |