Question Hospice - Coding for odd-scenario Attending visit

acooper1

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We have a patient that was brought in for Hospice level of care, not qualifying for GIP (General Inpatient). Patient was very confused about what hospice meant. After lengthy discussion, patient is switching to our provider as Attending and we anticipate patient will be with us for at least next 30 days at Routine / Room and Board level of care. For us to bill as Attending, we need to complete H&P and all the fun stuff that goes with it. Here's where we are uncertain of how to code that E/M visit. Patient is temporarily staying with us for 30 days - so - does that mean we code the E/M as home / domiciliary?

Those codes are categorized as:
Home or residence services codes are reported by providers for E/M services rendered to new patients in a home or residence, including a private residence or temporary lodging. Short-term accommodations such as a hotel, campground, hostel, or cruise ship are included, along with an assisted living facility, group home, custodial care facility, and residential substance abuse treatment facility. All services require a medically appropriate history and/or examination. Code selection is based on the level of medical decision making (MDM) or total time personally spent by the physician and/or other qualified health care professional(s) on the date of the encounter.

Or would we consider this a general outpatient E/M where they are in our hospice house, but not technically inpatient? (IE: 9921X / 9920X).

This one is a wee bit confusing :)
 
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