How To Use CPT Code 99501

CPT 99501 describes the home visit for postnatal assessment and follow-up care provided by a home health provider, such as a registered nurse. 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 99501?

CPT 99501 can be used to describe the home visit services provided by a home health provider to assess the health status of a patient and her newborn. During the visit, the provider may perform wound care, evaluate medical equipment needs, provide education on breastfeeding and lactation, instruct on infant care and recognizing signs of illness, assess the home environment for safety, and evaluate the newborn for jaundice. The provider may also review plans of care for the patient and newborn, educate on required immunizations and additional services, and determine if any conditions require a physician’s attention.

2. Official Description

The official description of CPT code 99501 is: ‘Home visit for postnatal assessment and follow-up care.’

3. Procedure

1. A home health provider, such as a registered nurse, visits the patient and her newborn at home.
2. The provider assesses the health status of the patient and newborn, including wound care, evaluation of medical equipment needs, and assessment of the home environment for safety.
3. Educational services may include instruction on breastfeeding and lactation, infant care, recognizing signs of illness, and required immunizations.
4. The provider may also review plans of care for the patient and newborn, and determine if any conditions require a physician’s attention.

4. Qualifying circumstances

Patients eligible to receive CPT 99501 services are those who have recently given birth and require postnatal assessment and follow-up care. The home visit is performed by a home health provider, such as a registered nurse. The provider assesses the health status of the patient and newborn, provides wound care if necessary, evaluates medical equipment needs, educates on breastfeeding and lactation, instructs on infant care and recognizing signs of illness, assesses the home environment for safety, and reviews plans of care. The provider may also educate on required immunizations and additional services, and determine if any conditions require a physician’s attention.

5. When to use CPT code 99501

CPT code 99501 should be used when a home health provider, such as a registered nurse, performs a home visit for postnatal assessment and follow-up care. This code is appropriate for patients who have recently given birth and require evaluation of their health status, wound care, education on breastfeeding and lactation, instruction on infant care and recognizing signs of illness, assessment of the home environment for safety, and review of plans of care. It is important to note that CPT code 99501 should not be used for routine prenatal or antenatal care.

6. Documentation requirements

To support a claim for CPT 99501, the home health provider must document the following information:

• Health status assessment of the patient and newborn
• Wound care provided, if applicable
• Evaluation of medical equipment needs
• Educational services provided, such as breastfeeding and lactation instruction, infant care instruction, and recognizing signs of illness
• Assessment of the home environment for safety
• Review of plans of care for the patient and newborn
• Educational information on required immunizations and additional services
• Determination of any conditions requiring a physician’s attention
• Signature of the home health provider

7. Billing guidelines

When billing for CPT 99501, ensure that the service is provided by a home health provider, such as a registered nurse. The visit should be for postnatal assessment and follow-up care. It is important to note that CPT code 99501 should not be reported with other codes for routine prenatal or antenatal care.

8. Historical information

CPT 99501 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 performing a home visit to assess the health status of a patient who recently gave birth and provide wound care for an episiotomy.
2. A home health provider evaluating the medical equipment needs of a patient and her newborn during a home visit.
3. An experienced nurse educating a patient on breastfeeding and lactation during a postnatal home visit.
4. A registered nurse instructing a patient on infant care and recognizing signs of illness during a home visit.
5. A home health provider assessing the home environment for safety and reviewing plans of care for a patient and her newborn during a postnatal visit.
6. A registered nurse educating a patient on required immunizations and additional services during a home visit.
7. A home health provider determining if a patient or newborn has any conditions that require a physician’s attention during a postnatal visit.
8. A registered nurse providing wound care for a patient who underwent a C-section during a home visit.
9. A home health provider evaluating the newborn for jaundice during a postnatal visit.
10. A registered nurse reviewing plans of care for a patient and her newborn during a home visit.