Which scenario would be inappropriate to use modifier 5902?

• A. Real-time video counseling via telehealth
• B. Store-and-forward asynchronous counseling
• C. Video counseling modality
• D. Telehealth video session for counseling

Answer: (B)

Telemedicine billing distinguishes between live, interactive encounters and asynchronous ones. Modifier 5902 is used to indicate a live, real-time telehealth session with active interaction. Store-and-forward asynchronous counseling does not involve simultaneous communication; the information is collected and reviewed later, not in a real-time exchange. Because 5902 flags a live session, applying it to store-and-forward would be inappropriate. The other scenarios describe real-time video or telehealth sessions where a live connection exists, so they fit the use of a telemedicine modifier. For store-and-forward, use asynchronous coding practices instead of a live-telemedicine modifier.