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PneumoVax - given at patienthome

Karen Posted Tue 17th of April, 2012 14:31:56 PM

If the a MD does a home visit (99348) & administers Pneumovax. Can he bill 90732 & G0009 in addition to the home visit?

SuperCoder Answered Tue 17th of April, 2012 16:04:00 PM

If the doctor performs a procedure (90732 or G0009) during a home visit, be sure to code that in addition to the home services code.

Documenting the medical reason that the patient needs treatment at home is more difficult. Section 15515 of the Medicare Carriers Manual says the home services codes can be used when a physician provides E/M services to a patient in a private residence. The patient does not have to be confined to the home (as is necessary for services provided under the home health benefit) but the “medical record must document the medical necessity of the home visit made in lieu of an office or outpatient visit,” the MCM says

That leaves it up to physicians to interpret when a payer may consider it medically necessary for them to see a patient at home.

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