Wiki E/M code for physician visit in a substance abuse Rehab facility

[jrine]

Hi,

I have a doubt and if someone can help me to clarify this doubt, it will be greatly appreciated.

One of my Dr is an addiction medicine physician and he is treating his patients in his clinic. Dr is also visiting his patients in a residential substance abuse rehabilitation facility. So what should be the E/M code for the rehab facility visits. I m not quite sure how to determine if these are considered out patients or inpatients. Patients spend 30 -90 days at the facility but it is not staffed 24 hrs per day with nurses and the patients administer their own medications which are ordered from an outpatient pharmacy and delivered to them. Can we use 99201 to 99205?

 

[SharonCollachi]

These are considered outpatient, since it is not staffed 24 hours/day for medical services.

As far as CPT codes, we would need to know a little bit more about what he is doing there. Is he doing a regular medical exam? Is it more along the lines of psych care - mental health and substance abuse are so close together that benefits for them are almost always lumped together into mental health/substance abuse. If he is doing psych services, you would look at the psych section of the CPT book.

99201-99205 are new patients - are these patients new to him?

 

[jrine]

Yes Dr is doing a regular medical exam. Giving medication assisted treatments. Seeing both new as well as established patients