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CPT E/M-home service

JanetU

Member
Blitzer
Hi guys,

For this question:

A physician makes a home care visit on a 63 year old patient that is a hemiplegic having insomnia for the last two weeks. The patient has been home bound for the last year. The last visit from this physician was four months ago to control his DM. The physician performs an expanded problem-focused examination and low MDM. The physician then speaks with the spouse about the possibility of placing the patient in a nursing facility. What CPT code is reported?

-->The answer is 99348.

For established patients, two out of three elements are required. So we drop the lowest level, and code to the next lowest level. Based on the provided information, is it possible to determine the history level? If not, how do we accurately select the correct code? I would highly appreciate your help.
 

Laureen

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Blitzer
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So it looks like you have a ?, E, L - as you pointed out it is a 2 of 3 situation for this establised home visit so you can drop one and that would be the history since you don't have it. Even if it was detailed or or comprehensive history you'd still be be brought down to a 99348.

 
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