We're working on Hospital @ Home implementation. CMS provides guidance for rev code and occurrence codes for the facility claim but no guidance for the physician/APP profee claim. CMS otherwise states "bill as though the patient were an IP". My question relates to billing for the physician's/APP's professional visits (in-person or telehealth). I polled 3 institutions and all 3 have different interpretations:
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Institution #
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CPT
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POS
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#1
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Home E&Ms 99341-99350
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POS 12 (in-person at patient's home) and POS 10 for telehealth visits
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#2
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Inpatient E&Ms (9922x- 9923x)
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IP visit CPT (9922x, 9923x) and POS 21 Inpatient Hospital (in-person and telehealth)
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#3
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Inpatient E&Ms (9922x- 9923x)
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POS 12 (in-person at patient's home) and POS 10 for telehealth visits
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Has anyone seen or received specific profee claim instruction directly from CMS or their MAC?
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Karen Smith
Vice President, Billing Compliance
University of Pennsylvania Health System
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