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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 settingSensitivitySpecificityPPVNPV
Any telemedicine visit (using GT, GQ, or 99444)
All inpatient & outpatient encounters100%
(−-)
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 visit100%
(−-)
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 encounter100%
(−-)
99.98%
(99.97–99.99%)
55.2%
(36.6–72.4%)
100%
(−-)
- Inpatient consultation100%
(−-)
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 encounters100%
(−-)
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 visit100%
(−-)
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 encounter100%
(−-)
99.98%
(99.97–99.99%)
55.2%
(36.6–72.4%)
100%
(−-)
- Inpatient consultation100%
(−-)
99.9%
(99.7–99.97%)
66.7%
(26.8–91.6%)
100%
(−-)
Store and Forward Telemedicine (using GQ or 99444)
All inpatient & outpatient encounters100%
(−-)
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%
(−-)
  1. Note: Abbreviations: PPV positive predictive value; NPV negative predictive value