Pulmonology Coding Alert

Question: A physician evaluates a new patient in an assisted living facility for hypertension. Should we bill it as 99339 or 99340? Michigan Subscriber Answer: Neither. Clearly, the patient received a faceto-face E/M service that was provided in a domiciliary or rest home environment. You should not confuse it with codes for care plan oversight (CPO) of a patient in a home, domiciliary, or rest home, which includes an assisted living facility (99339-99340). Instead, use E/M service codes for new-patient domiciliary, rest home, or custodial care services (99324-99328), depending on the documented level of the service. Example: Suppose the physician visited the new patient in the assisted living facility and was able to assess the patient's medical condition from a problem focused history and problem focused examination and proceeded to treat and manage the patient using straightforward medical decision making all in 20 minutes. You would report it as 99324 [...]