QUESTION:
Ruth Sheets:
This question was asked as a chat question during the webinar. Any ideas?
Q #21: CPT code 99509 - how is this paid? for example: 8 hours = 1 unit or 15 minutes = 1 unit or 24 hours = 1 unit
ANSWER THREAD:
Ruth Sheets:
From Supercoder.com:
99509 Home visit for assistance with activities of daily living and personal care
Lay Term:
A home health provider, such as a registered nurse, or a non-nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.
Clinical Responsibility:
ADLs include bathing, dressing, grooming, eating, using the bathroom, walking, and transferring from one location to another, such as from a wheelchair to the bed. The provider assists the patient with these activities, based on a care plan established with the physician, patient, and family members.
I could not find any time guidelines. It does seem unlikely that a home health provider spending 1 hour should be paid the same as one that spends 8 hours, for example.
Debra Locke:
I know this is a late response by far Ruth but I will weigh in. I am actually working on a clinical review right now that involves a Home Health provider and encompasses HCPCS code services for Home Attendants through Skilled Nursing Care.
My first guess is that unless the payor is requesting that the CPT code be used for some reason the guidelines around using the codes where the most specificity lies would be my recommendation. In this case, I think the service described above would match the Home Health Aide HCPCS Code S9122 which is Home health aide or certified nurse assistant, providing care in the home; per hour
Your thoughts?
~Deb
Ruth Sheets:
S9122 seems like a better choice if the payor accepts it.
Thanks for your input, Deb!
Ruth Sheets:
This question was asked as a chat question during the webinar. Any ideas?
Q #21: CPT code 99509 - how is this paid? for example: 8 hours = 1 unit or 15 minutes = 1 unit or 24 hours = 1 unit
ANSWER THREAD:
Ruth Sheets:
From Supercoder.com:
99509 Home visit for assistance with activities of daily living and personal care
Lay Term:
A home health provider, such as a registered nurse, or a non-nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.
Clinical Responsibility:
ADLs include bathing, dressing, grooming, eating, using the bathroom, walking, and transferring from one location to another, such as from a wheelchair to the bed. The provider assists the patient with these activities, based on a care plan established with the physician, patient, and family members.
I could not find any time guidelines. It does seem unlikely that a home health provider spending 1 hour should be paid the same as one that spends 8 hours, for example.
Debra Locke:
I know this is a late response by far Ruth but I will weigh in. I am actually working on a clinical review right now that involves a Home Health provider and encompasses HCPCS code services for Home Attendants through Skilled Nursing Care.
My first guess is that unless the payor is requesting that the CPT code be used for some reason the guidelines around using the codes where the most specificity lies would be my recommendation. In this case, I think the service described above would match the Home Health Aide HCPCS Code S9122 which is Home health aide or certified nurse assistant, providing care in the home; per hour
Your thoughts?
~Deb
Ruth Sheets:
S9122 seems like a better choice if the payor accepts it.
Thanks for your input, Deb!