Wiki House Call

[Skymom16]

Hi,
I'm in a dilemma and NEED HELP, i bill for gastroenterology and one of our physicians did a house call with a peg replacement on a medicare patient . My question is can i bill for a house call visit and if so E/M code would i use ? PLEASE HELP

Thanks

 

[Pathos]

So first things first, what was the purpose of the home visit? Medicare has pretty straightforward rules about home visits and medical necessity. Could the patient have been seen in the office with little problem, or did the physical/mental condition(s) prevent the patient from being seen in the office?

If documentation is strong enough to cover medical necessity, then documentation would also need to cover the standard requirements of an E/M visit (History, Exam, MDM). Also, don't forget about using the correct Place of Service code.

I would really need to know more about the visit before I can guide you further, but here is some additional readings:

CMS E/M guidelines

Noridian (my local MAC) Home and Domiciliary Visit guidelines

AAPC article on Home Visits

Hope that helps!