AAHCM HCCI Pre-Conference Session: Level Up! Take Your House Call Operations to New Heights-HCCI E

HCCI E_M Guide for Home Visits

Pdf Summary

The document provides a detailed breakdown of CPT (Current Procedural Terminology) Evaluation and Management (E/M) codes for home and domiciliary visits, differentiating between new and established patients. Each code is associated with various time increments and detailed requirements for key components: History, Examination, and Medical Decision Making (MDM).<br /><br />For new home visits (POS 12), codes range from 99341 to 99345. The time spans from 20 to 75 minutes, with increasing complexity in history, examination, and MDM. For instance, code 99341 requires a problem-focused history and examination with straightforward MDM, while code 99345 involves comprehensive history and examination with high complexity MDM.<br /><br />Established home visit codes range from 99347 to 99350, requiring two out of three components met per level of service or appropriate time for counseling/coordination of care. Time ranges from 15 to 60 minutes, progressing similarly in complexity from problem-focused (99347) to comprehensive (99350), the latter suitable for moderate to high complexity MDM.<br /><br />For new domiciliary visits, the codes range from 99324 to 99328, with similar time increments and increasing complexity levels similar to new home visits. For example, 99324 is appropriate for a 20-minute visit with a problem-focused history and examination, while 99328 is for 75 minutes with comprehensive history and examination, and a high level of MDM.<br /><br />Established domiciliary visits use codes 99334 to 99337. These codes also hinge on achieving two out of three required components for each level of service or the designated time for counseling/coordination of care. Complexity and detail requirements progress from problem-focused (99334, 15 minutes) to comprehensive (99337, 60 minutes), with the latter requiring moderate to high complexity in MDM.<br /><br />In summary, these codes help standardize the recording and billing of home and domiciliary patient visits, ensuring clarity and uniformity in expected time, history taking, examination, and decision-making levels.

Keywords

CPT codes

Evaluation and Management

home visits

domiciliary visits

new patients

established patients

History

Examination

Medical Decision Making

billing