Primary Care Coding Alert

A 2001 Medicare transmittal offers a clear answer to a question that has been plaguing FP coders: How should you bill for physician visits to residents in assisted-living facilities?

Transmittal 1690 (later revised to correct errors in the place-of-service codes in Transmittal 1709) says that the domiciliary, rest home or custodial services codes (99321-99333) should be used to report E/M services for residents of a facility that provides "room, board and other personal assistance services, generally on a long-term basis." The transmittal notes that these facilities, which do not have a medical component, are often referred to as "adult living facilities or assisted-living facilities." List codes 99321-99323 for new patients, and 99331-99333 for established patients. Make sure to report place-of-service code 33 to indicate assisted-living center.

Coders who report home services codes for E/M services provided in assisted-living centers are in error, according to the transmittal. Medicare says that 99341-99350, the home services codes, are for use only when E/M services are provided to a patient in his or her "own private residence and not any type of facility."