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Issue Number - Name
0011 - Inappropriate Billing of Home Visit Professional Service E&M Codes during Inpatient
Review Type
Automated
Claim Type
Professional Services (Physician/ non Physician Practitioner
Region and State
RAC 1-4
All States
Date Approved
2017-02-01

Description

Home Services Billed for Hospital Inpatients - Home Services CPT Codes may not be used for billing services provided in settings other than in the private residence of a beneficiary.

Affected Codes

  • CPT Code 97535, 99341-99345, 99347-99350

Applicable Policy References

  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6.14
  • CPT Manual, 2013-present