Pediatric Coding Alert

Question: A child stepped on a rusty nail and developed Pseudomonas osteomyelitis. After the pediatrician initiated intravenous antibiotic therapy in the hospital, she sent the child home and ordered a home health agency to continue the treatment. The pediatrician occasionally talks to the home health agency about the patient's progress and keeps track of how well the family is doing. The pediatrician spends a lot of time completing the home health agency's paperwork. Is there a way to bill for the pediatrician's time performing these postdischarge services?

Texas Subscriber

Answer: Yes, you should report the time that the pediatrician spends supervising the home health care agency's care of the patient with care plan oversight (CPO) codes 99374-99375.
 
If the pediatrician performs and documents that she spends 15-29 minutes in a given month reviewing the patient's care plan, records, reports and/or communicating with the healthcare professional(s) and family, you should submit 99374 (Physician supervision of a patient under care of home health agency [patient not present] in home, domiciliary or equivalent environment [e.g., Alzheimer's facility] requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication [including telephone calls] for purposes of assessment or care decisions with healthcare professional[s], family member[s], surrogate decision maker[s] [e.g, legal guardian] and/or key caregiver[s] involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes).
 
If she spends more than 29 minutes, you should submit the CPO services with 99375 (... 30 minutes or more).
 
You must carefully document the time increments that you spend on a daily basis. That way, you can accurately count the month's total time.
 
Handy tool: Keep a note in the patient's chart so you can easily keep track of each minute.