Question

Using insurance terms

Case 13.3 Using Insurance Terms 

 

Read this information from a Medicare carrier and answer the questions that follow. 

 

E&M services rendered in a private residence are correctly billed with CPT codes 99341–99345 (new patients) and CPT codes 99347–99350 (established patients), home services. These CPT codes are payable only in home settings, that is, place of service 12. 

 

National Government Services has seen many instances of providers billing outpatient/office codes in home set¬tings. Home visits should not be reported with E&M codes 99201–99215, which represent office and outpatient services. 

 

A. LO 13.3 Based on Table 13.2, what claim adjustment reason code will result if this code is billed 99201, POS 12? 

 


 

B. LO 13.3 Which Remark Code would appear, N210 or N211?

 



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