READER QUESTIONS:
Prove Medical Necessity Before Billing House Calls
Published on Sat Nov 21, 2009
Question: Our podiatrist sometimes gets requests for house calls from senior patients. The CPT manual provides codes for house calls and domiciliary care. How do I ensure that our doctor gets reimbursed? Wisconsin Subscriber Answer: To make sure that your doctor gets paid for home service, you will need to provide the correct code from the home visit series depending on whether the patient is new (99341-99345, Home visit for the evaluation and management of a new patient ...) or established (99347-99350, Home visit for the evaluation and management of an established patient ...). Plus, make sure you also have documentation that shows that the home visit was medically necessary. This is particularly true for Medicare patients. Here's why: Medicare guidelines require a written record showing that the house call was a better option for the patient than an office or outpatient visit. The records must stipulate that the patient [...]