Wiki Home Visit Coding?

[Lynelle]

I think my doc is the only one who still does home visits. He recently did a home visit to consult a newly diagnosed lymphoma for an 80+ year old patient. I coded it as 99348, but Medicare Part B is not paying it. How should I code this one?

Thanks!

 

[Donna T]

I believe the original post said it was a home visit and not a nursing home visit so the nursing home G code wouldn't apply here. What did the denial from medicare say? Did you use a POS 12 when you did the billing and was the patient an established pt or a new patient?

 

[vmontejo]

Couple things to look out for, assuming everything else was coded properly, are:

1) Is the patient on hospice? If so, you will need to apply the appropriate modifier.
2) is there a global period applying to the home visit.
3) Was an E/M code billed for that Date of service by your provider?

Without the reason for denial it is kind of hard to say, but maybe these suggestions might help.