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lillianbarker

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I have an Office visit that occurred during AM. Later in afternoon, doc called to the patients house and was there for 4 hours. The diagnosis is the same issue. How would you code this?
 
lillianterry said:
I have an Office visit that occurred during AM. Later in afternoon, doc called to the patients house and was there for 4 hours. The diagnosis is the same issue. How would you code this?
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I'd report the office E/M (99201-99215) for the morning (with POS code 11), and something from the 99347 - 99350 range for the home visit (with POS code 12). I'd add a 25 modifier to the home visit, and if the documentation's good enough, I'd consider using a prolonged services code (99354-99355), to account for the extra time spent at the patient's home.

I hope that he's got stellar documentation, because there's a good chance that you're going to receive a denial, and have to appeal with medical records. :o

Who is the payer?
 
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