deivanaiv
Contributor
Hi All,
We have taken up a new Project where Transitional Care is given to patients by RN, LPN, PT, OT etc at patient's home. Since care is given at patient's home, services are coded as home health visit .
But it looks like this is totally different from the Home Health we were doing earlier.
Need some advice on how to Code these services. The members of this healthcare group does not belong to home health agency. They provide services to patients in order to avoid frequent re-admission to hospital/ ED for the treated condition.
RN/LPN /PT/OT visit a patient's home weekly twice or thrice to observe patient's condition and provide necessary services like wound dressing , exercises therapy etc. The Initial visits were coded with 99495 / 96 and the Subsequent visits were billed with the G-Codes. There are a lot of recoupments happening stating "Do not have authorization", we're just not able to move forth as we have no idea how these TCMs are Coded, billed and reimbursed.
Need advice on:
Regards,
Deivanai
We have taken up a new Project where Transitional Care is given to patients by RN, LPN, PT, OT etc at patient's home. Since care is given at patient's home, services are coded as home health visit .
But it looks like this is totally different from the Home Health we were doing earlier.
Need some advice on how to Code these services. The members of this healthcare group does not belong to home health agency. They provide services to patients in order to avoid frequent re-admission to hospital/ ED for the treated condition.
RN/LPN /PT/OT visit a patient's home weekly twice or thrice to observe patient's condition and provide necessary services like wound dressing , exercises therapy etc. The Initial visits were coded with 99495 / 96 and the Subsequent visits were billed with the G-Codes. There are a lot of recoupments happening stating "Do not have authorization", we're just not able to move forth as we have no idea how these TCMs are Coded, billed and reimbursed.
Need advice on:
- Can G-Codes be billed for these services or should we use any specific 9 series codes since they does not belong to home health agency
- Are there any other pre-requisites that we need to get from the Hospital in order to Code as well as bill for these services
- Should we use any specific modifiers/ indicators related to coding/ billing when coding or submitting the claims.
Regards,
Deivanai