Neurology & Pain Management Coding Alert

Question: One of our neurologists occasionally visits patients at their homes to evaluate advanced diabetic patients with mobility difficulties or other debilitating conditions. How should we report home visits? New Jersey Subscriber

Answer: You should code home visits similarly to the way you report regular office visits. When the physician performs an E/M service in the private residence of a new patient, you should choose from the 99341-99345 series (Home visit for the evaluation and management of a new patient ...). For established patient visits, use 99347-99350 (Home visit for the evaluation and management of an established patient ...).

As with in-office visits for new patients, your physician must meet all of the requirements for history, examination and decision-making to correctly use 99341-99345. You have to meet two of those requirements when using 99347-99350. Remember: The medical record should document that your physician was present in the patient's home. And the record must support a medically necessary reason for the home visit in lieu of an office visit. The patient doesn't have to be confined to the home but must have a chief complaint.