Practice
The AAAAI offers educational resources and information on practice operations for allergist/immunologists. Take advantage of these tools to help assess the risk of COVID-19 in your region and apply best practices in patient care.
Practice operations depend on a risk assessment of community spread of cases and your state’s current rate of vaccination. It is important to realize that this is a fluid and changing environment, that risk may change with time and decisions may need to change.
Telemedicine
Many practices are continuing to utilize telemedicine to see patients.
Regulations/changes
The CMS changes relative to telehealth will remain in place until at least the end of 2024.
Coding/Reimbursement
Commercial insurance rules regarding telemedicine vary by state. Check with the individual payer or your state medical society for the most up to date guidance. You can also encourage your patients to check with their insurance provider for information on coverage of telemedicine visits.
Find out more about telemedicine from the AAAAI.
Payer websites
Aetna: https://www.aetna.com/health-care-professionals/covid-faq/telemedicine.html
United Healthcare: https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/covid19-telehealth-services.html
Cigna: https://static.cigna.com/assets/chcp/resourceLibrary/medicalResourcesList/medicalDoingBusinessWithCigna/medicalDbwCVirtualCare.html
Helpful Resources for Telemedicine
AAAAI Telemedicine Toolkit
Help patients prepare for a telemedicine visit: 10 Tips to Help You Master Your Telemedicine Visit: A Patient Guide
CMS Telehealth Toolkit for General Practitioners
Updated CMS Medicare fee-for-service FAQs. Telehealth guidance begins on page 35 and includes additional guidance related to telephone-only codes (Q24), billing of disconnected telehealth visits (Q25) and consent requirements for certain telehealth and other virtual visits (Q32).
The Joint Taskforce on Technology and Telemedicine developed several short videos on practicing telemedicine during the pandemic:
COVID-19 Coding
The AMA, in cooperation with CMS, has released new codes for specific vaccine products. A spreadsheet of all the COVID-19 testing, vaccine and vaccine administration codes can be downloaded here.
CMS has a list of specific COVID 19 vaccine codes and payment allowances and a comprehensive toolkit for providers with the information needed to administer and bill for the vaccines.
External Resources
AMA: A physician's guide to COVID-19
American College of Physicians (ACP): COVID-19 Practice Management Resources
Centers for Disease Control and Prevention (CDC): COVID-19 information for healthcare workers
Elsevier Novel Coronavirus Information Center
Food and Drug Administration (FDA) Guidance on Conduct of Clinical Trials of Medical Products During the COVID-19 Public Health Emergency
National Institute of Allergy and Infectious Diseases (NIAID) Strategic Plan for COVID-19 Research: 2021 update
US Pharmacopeial Convention (USP) COVID-19 Vaccine Handling Toolkit
Pediatric Patients
Case and Hospitalization Rates
Hospital Data Compared with Vaccination Coverage
This study demonstrated that ER visits and hospitalizations are four times greater in areas with low vaccine coverage compared to those with high vaccine coverage. (MMWR, Sept 10, 2021)
Schools/Transmission
Pediatric Household Transmission of SARS-CoV-2 Infection
This study is particularly relevant as school reopens across the United States. It did take place prior to the dominance of the Delta variant. The study was done in Ontario, Canada and involved 6,280 households with pediatric index cases. 1,717 households (27.3%) experienced secondary transmission. The age group with the highest odds of transmitting the infection to household contacts compared with children aged 14-17 was the 0-3 year age group (1.43, 95% CI 1.17-1.75). Children in the 4-8 year age group also had a higher odds ratio (1.40, 95% CI 1.18-1.67). Since these age groups cannot be vaccinated, it is important for parents to take other precautions and be sure that the school or daycare is doing the same. As allergists who care for pediatric patients or young adults with children, we need to be aware of the family dynamics, childcare and school status in order to counsel our patients about prevention and precaution.
Guides for Masks for Children
Now that it is back to school time, some of your patient’s parents may ask which mask is best for their child. There are good resources here and here.
External Resources for Pediatric Patients
AAP Critical Updates
CDC COVID-19 Data Tracker – Pediatric Data
Children and COVID-19: State-level Data Report (Note: updates stopped in May 2023.)
Ask the AAAAI
See what other AAAAI members are asking the COVID-19 Task Force about their patients and practices:
Asthma
Immunocompromised Patients
Other Important Issues
Vaccines
External Resources
Preparing the Allergist/Immunologist for the Next Pandemic, Williams, Paul V. et al. The Journal of Allergy and Clinical Immunology: In Practice, Volume 11, Issue 11, 3373 – 3379
American College of Physicians (ACP): COVID-19 Information for Internists
American Academy of Pediatrics (AAP): Critical updates on COVID-19
Centers for Disease Control and Prevention (CDC) COVID-19 Resources
Schools and child care programs
Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults: A Systematic Review JAMA Netw Open. 2021;4(9):e2126456