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Mobile Unit E/M Codes

Kim Posted Thu 31st of January, 2019 16:03:34 PM
I am a Home Health Provider with no designated office. If we have a mobile medical unit, what POS and E/M codes should we be billing? We typically bill assisted living or home visits, not standard E/M codes (such as 99213). Per Medicare Guidelines, I understand that we are instructed to bill typical E/M codes, however, since we do not have an office and only do travel-medicine is it appropriate to bill the standard office E/M codes (such as 99213)?
SuperCoder Answered Fri 01st of February, 2019 05:30:22 AM

Hi Kim,

As mentioned in the above documentation that you have a mobile medical unit, the place of service (POS) used will be 15. However,

When services are furnished in a mobile unit, they are often provided to serve an entity for which another POS code exists. For example, a mobile unit may be sent to a physician’s office, a skilled nursing facility or assisted living facility. If the mobile unit is serving an entity for which another POS code already exists, providers should use the POS code for that entity. However, if the mobile unit is not serving an entity which could be described by an existing POS code, the providers are to use the Mobile Unit POS code 15. Apply the nonfacility rate to payments for services designated as being furnished in POS code 15; apply the appropriate facility or nonfacility rate for the POS code designated when a code other than the mobile unit code is indicated.

In your scenario you typically bill assisted living or home visits. So, the assisted living facility is in the same category as rest home, boarding home or custodial care services facility. These type of facilities have no organized, full-time medical component as do the nursing facilities. The assisted living centers or boarding/custodial care residences provide room, board and other personal assistance services, generally on a long-term basis.

For these facilities the POS is 13 and CPT codes 99324-99328 (new patient) and 99334-99337 (established patient) are appropriate.

For further assistance you may also refer to the link below.

http://www.sccma-mcms.org/Portals/19/assets/docs/Nursing-Facility-Services-POS.pdf

Kim Posted Fri 01st of February, 2019 12:15:37 PM
Thank you for the response, but I am still lacking clarification on whether or not to use the 99324-99328/99334-99337 and POS 13 if the mobile unit is parked outside of an assisted living facility? Also, if we bring the mobile unit to the patients home, would we use POS 12 and the 99341-99345/99347-99350?
SuperCoder Answered Mon 04th of February, 2019 04:16:32 AM

As per CMS guidelines, there is a special consideration for mobile unit settings (Code 15)

When services are furnished in a mobile unit, they are often provided to serve an entity for which another POS code exists. For example, a mobile unit may be sent to a physician’s office, a skilled nursing facility or assisted living facility. If the mobile unit is serving an entity for which another POS code already exists, providers should use the POS code for that entity. However, if the mobile unit is not serving an entity which could be described by an existing POS code, the providers are to use the Mobile Unit POS code 15. Apply the nonfacility rate to payments for services designated as being furnished in POS code 15; apply the appropriate facility or nonfacility rate for the POS code designated when a code other than the mobile unit code is indicated.

So, seeing the above statement, it is correct to use the 99324-99328/99334-99337 and POS 13 if the mobile unit is parked outside of an assisted living facility, and to use POS 12 and the codes 99341-99345/99347-99350 if we bring the mobile unit to the patients’ home. Hope it helps.

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