Orthopedic Coding Alert

Question: One of our orthopedists visits patients at their homes occasionally to evaluate arthritis, hip replacements or other debilitating problems. 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.