Robert Posted Fri 01st of April, 2011 05:25:45 AM
I'm an Internist and make house-calls for my invalid patients. It generally takes me a total of 40 min of travel; I spend approximately 1h 15m with family/patient (beridden CVA), review all interval VNA documents, write necessary rx's, review all written-out changes for family (they're really over-whelmed and need written instructions) and I will email the visiting nurse with made changes. I'm billing a CPT: 99350 ($140)for the call; and a monthly CPT: G0180(CPO ($40). With monthly visits, I essentially keep this GT feed, CHF, Malignant HTN, out of the hospital. Total time for visit will equal about 2hrs (night freeway driving) and total reimbursement received on this (Medi-Medi) patient will be $112.00 (20% Medical is a write-off), then subtract gas cost and your payment adds up to a robust $100 for saving Medicare thousands at the hospital level.
After 6 monthly visits to date, I cannot keep my home service up unless there are Prolonged Codes I can add on to the existing E/M codes. Please advise me of further CPT codes I can submit to Medicare to justify my efforts. I only want to be made aware of additional/addendum codes which Medicare recognizes and pays. IE. can I use an equivalent 99354 and/or 99355 for a housecall meeting timehigh severity criteria? Thanks for any anticipated imput.
Regarding the CPO monthly payments of $32.00 or $8/week (20% MediCal write-off), if I have to spend at least an hour a month authorizing VNA orders, is there also a "Prolonged CPO" kind of code which I can post monthly in order to actually loose dollars on each call? This is a really fiscal area within my practice which will either dictate continued cost-saving services for Medicare, or reflex serial in-patient admissions, whenever the visiting nurse and/or family feels that Dad looks worse each day and then call an ambulance
SuperCoder Answered Fri 01st of April, 2011 21:39:53 PM
Submitting the range of CPT codes applicable in Home Health services. Please verify which all will you find justifiable in your case.
99500 Home visit for prenatal monitoring and assessment to include fetal heart rate, non-stress test, uterine monitoring, and gestational diabetes monitoring
99501 Home visit for postnatal assessment and follow-up care
99502 Home visit for newborn care and assessment
99503 Home visit for respiratory therapy care (eg, bronchodilator, oxygen therapy, respiratory assessment, apnea evaluation)
99504 Home visit for mechanical ventilation care
99505 Home visit for stoma care and maintenance including colostomy and cystostomy
99506 Home visit for intramuscular injections
99507 Home visit for care and maintenance of catheter(s) (eg, urinary, drainage, and enteral)
99509 Home visit for assistance with activities of daily living and personal care
99510 Home visit for individual, family, or marriage counseling
99511 Home visit for fecal impaction management and enema administration
99512 Home visit for hemodialysis
99600 Unlisted home visit service or procedure
99601 Home infusion/specialty drug administration, per visit (up to 2 hours)
99602 Home infusion/specialty drug administration, per visit (up to 2 hours); each additional hour (List separately in addition to code for primary procedure)