Medical Coding for Home Healthcare
New patient CPT codes
99341 – Home visit for the evaluation and management of a new patient. This visit requires the following three components:
- A problem-focused history
- A problem-focused exam
- Straightforward medical decision making
Counseling and/or coordination of care with other physicians, other qualified health care professionals, or other agencies are provided consistent with the nature of the problem(s) and the patients’ and/or family’s needs.
Usually, the presenting problem(s) are of low severity. Typically, the physician spends 20 minutes face-to-face with the patient and/or family.
99342 – Same as above, but this is a moderate severity problem requiring 30 minutes.
99343 – Moderate to high severity problem requiring 30 minutes.
99344 – High severity problem requiring 60 minutes.
99345 – Patient unstable or has a significant new problem requiring immediate attention (75 minutes).
Established patient CTP codes
99347 – Home visit for evaluating and managing an established patient. The visit requires at least two of these three key components.
- A problem-focused interval history
- A problem-focused examination
- Straightforward medical decision making
Counseling and/or coordination of care with other physicians, other qualified health care professionals, or other agencies are provided consistent with the nature of the problem(s) and the patients’ and/or family’s needs.
Usually, the presenting problem(s) are self-limited or minor. Typically, you spend 15 minutes face-to-face with the patient and/or family.
99348 – Same as above, but this problem is low to moderate severity requiring 25 minutes face-to-face.
99349 – Moderate to high problem requiring 40 minutes.
99350 – Patient unstable or has a significant new problem requiring immediate physician attention (60 minutes).
When making a house call, you may offer additional services such as advanced care planning, diagnosis services, or other minor procedures. These can be documented and billed in addition to the visit code.
Physicians making house calls should keep in mind specific reimbursement and practical considerations. Use these tips and CPT codes to bill for a house call visit.
mobius.md
www.novitas-solutions.com
Home Health Coding thread:
Coding for Home Heath can be tricky. There are rules to follow. Selecting a Primary DX is key. Coding under PDGM 1. Align OASIS ICDs with Referral Documentation from the Physician Medicare regulations require that a physician, with a current and active physician license, must order home health...
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