Q answers our clients' coding questions and ran these two items recently. I've included the questions and her comments, as I think it's time we pay a little attention to these rarely used codes. I'll hit you with some data tomorrow, but let's warm up. The answers are from Q.

Question number 1:

Can you help me figure this out? How would you code the following situation? Baby is born but then placed on Photo-therapy at home by home health services to treat a high bilirubin. Dr. has to order the blood tests and interpret the results for a period of about 4 days when the bilirubin has fallen to an acceptable level.

One day's supervision involves:

• Calling and ordering the blood to be drawn
• Tracking the result
• Calling the mother/health aid with result
• Deciding on further strategy

Up to this point we have never charged for any of this, but it seems to me that it would be legitimate to charge for all the calls, orders, and being interrupted with results sometimes by both the lab and the home health aid. What do you think? How should this be coded? Any help would be appreciated.

Answer #1:

By my guess the 99339 and 99340 codes are the ones you are looking for. They seem to describe, based upon time, the services included in your message. These codes are based upon total time spent for a complete calendar month. So, you will report this only once per calendar month of care and the code should be based upon total time spent for that entire calendar month.

I have one reservation about how this code compares to your description. CPT warns users not to report these codes when patients are under the care of home health. I can't tell specifically from your message if home health initiated care at home or if they remained involved throughout the full episode of care.

I would also advise that the provider rendering the care be sure to document the time spent during each care session (include durations of phone calls and/or consults/discussions) and list topics discussed.

Question #2:

Is it possible to charge for setting up a physical therapy program for a patient? If so - what code?

Depending upon the work being done that could qualify for Coordination of Care services (99339 and 99340). Based upon total time spent for a complete calendar month. So, you will report this only once per calendar month of care and the code should be based upon total time spent for that entire calendar month. CPT warns users not to report these codes when patients are under the care of home health. I would also advise that the provider rendering the care be sure to document the time spent during each care session (include durations of phone calls and/or consults/discussions) and list topics discussed/orders.

Back to me...so what's up next? A discussion about useage, values, good links about when to use them, etc.