How To Use CPT Code 99500

CPT 99500 describes the home visit for prenatal monitoring and assessment, including fetal heart rate monitoring, non-stress tests, uterine monitoring, and gestational diabetes monitoring. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 99500?

CPT 99500 can be used to describe the home visit services provided by a healthcare professional, typically a registered nurse, to monitor and assess a pregnant patient with pregnancy complications. This code encompasses various assessments, including fetal heart rate monitoring, non-stress tests, uterine monitoring, and gestational diabetes monitoring.

2. Official Description

The official description of CPT code 99500 is: ‘Home visit for prenatal monitoring and assessment to include fetal heart rate, non-stress test, uterine monitoring, and gestational diabetes monitoring.’

3. Procedure

1. During the home visit, the healthcare professional, usually a registered nurse, monitors the fetal heart rate using a special stethoscope.
2. The healthcare professional may also conduct non-stress tests, which involve attaching two sensors to the patient’s abdomen using elastic belts. One sensor measures the fetus’ heart rate using ultrasound, while the other measures fetal movement and contractions.
3. The patient is instructed to press a button connected to the equipment whenever she feels the fetus move. The healthcare professional compares the heart rate during movement and at rest.
4. In addition to fetal monitoring, the healthcare professional may also measure the patient’s sugar level to monitor gestational diabetes using a blood glucose meter.

4. Qualifying circumstances

CPT 99500 is used for pregnant patients with pregnancy complications who require home visits for monitoring and assessment. The healthcare professional must be a registered nurse or another qualified healthcare professional. The services provided include fetal heart rate monitoring, non-stress tests, uterine monitoring, and gestational diabetes monitoring.

5. When to use CPT code 99500

CPT code 99500 should be used when a healthcare professional, typically a registered nurse, conducts a home visit to monitor and assess a pregnant patient with pregnancy complications. This code is appropriate for services that include fetal heart rate monitoring, non-stress tests, uterine monitoring, and gestational diabetes monitoring.

6. Documentation requirements

To support a claim for CPT 99500, the healthcare professional must document the following information:

• Patient’s pregnancy complications and the need for home visits for monitoring and assessment
• Specific assessments performed, such as fetal heart rate monitoring, non-stress tests, uterine monitoring, and gestational diabetes monitoring
• Date and duration of the home visit
• Results of the assessments and any relevant findings
• Any recommendations or follow-up care provided
• Signature of the healthcare professional conducting the home visit

7. Billing guidelines

When billing for CPT 99500, ensure that the services are provided during a home visit for prenatal monitoring and assessment. The healthcare professional conducting the visit should be a registered nurse or another qualified healthcare professional. There are no specific guidelines regarding reporting CPT 99500 with other codes.

8. Historical information

CPT 99500 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates to the code since its addition.

9. Examples

1. A registered nurse conducting a home visit to monitor the fetal heart rate and perform non-stress tests for a pregnant patient with high blood pressure.
2. A healthcare professional visiting a pregnant patient with gestational diabetes to monitor the fetal heart rate and assess blood sugar levels.
3. A registered nurse conducting a home visit to monitor uterine activity and perform non-stress tests for a pregnant patient with a history of preterm labor.
4. A healthcare professional visiting a pregnant patient with a previous stillbirth to monitor the fetal heart rate and assess uterine activity.
5. A registered nurse conducting a home visit to monitor the fetal heart rate and perform non-stress tests for a pregnant patient with a history of fetal growth restriction.
6. A healthcare professional visiting a pregnant patient with a multiple gestation to monitor the fetal heart rate and assess uterine activity.
7. A registered nurse conducting a home visit to monitor the fetal heart rate and perform non-stress tests for a pregnant patient with a history of placental abruption.
8. A healthcare professional visiting a pregnant patient with a history of pre-eclampsia to monitor the fetal heart rate and assess uterine activity.
9. A registered nurse conducting a home visit to monitor the fetal heart rate and perform non-stress tests for a pregnant patient with a history of stillbirth.
10. A healthcare professional visiting a pregnant patient with a history of preterm labor to monitor the fetal heart rate and assess uterine activity.