Primary Care Coding Alert

Question: One of our physicians evaluated a new patient in an assisted living facility for sinusitis. Should we bill the encounter as 99339 or 99340?Washington Subscriber Answer: Neither code applies to the situation. The patient received a face-to-face E/M service that your physician provided in a domiciliary or rest home environment. Don't confuse the circumstances with codes for care plan oversight (CPO) of a patient in a home, domiciliary, or rest home, which includes an assisted living facility (99339-99340). Instead, use E/M service codes for new-patient domiciliary, rest home, or custodial care services (99324-99328), depending on the documented level of the service. Example: Suppose the physician visited the new patient in the assisted living facility and was able to assess the patient's medical condition and documented a problem focused history and problem focused examination and proceeded to treat and manage the patient using straightforward medical decision You would report 99324 [...]