How To Use CPT Code 99502

CPT 99502 describes the home visit services provided by a home health provider, such as a registered nurse, to evaluate a newborn and provide newborn care education to the patient. 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 99502?

CPT 99502 can be used to describe the home visit services provided by a home health provider to assess the health status of a newborn and provide education to the patient. This code is used when a registered nurse or other qualified provider conducts a physical examination, including vital signs, and offers instructions on breastfeeding, infant care, recognizing signs of illness, assessing the home environment for safety, and evaluating the newborn for jaundice.

2. Official Description

The official description of CPT code 99502 is: ‘Home visit for newborn care and assessment.’

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 newborn, conducting a physical examination and taking vital signs.
3. During the visit, the provider educates the patient on breastfeeding and lactation, provides instructions on caring for the infant, and teaches the patient how to recognize signs of illness.
4. The provider also assesses the home environment for safety and evaluates the newborn for jaundice.
5. If necessary, the provider may review plans of care for the newborn and determine if any conditions require a physician’s attention.

4. Qualifying circumstances

Patients eligible to receive CPT 99502 services are those with a newborn who require home visit services for newborn care and assessment. The home health provider must be a registered nurse or another qualified professional. The visit includes a physical examination, vital signs assessment, education on breastfeeding and lactation, instructions on infant care and recognizing signs of illness, assessment of the home environment for safety, and evaluation of the newborn for jaundice.

5. When to use CPT code 99502

CPT code 99502 should be used when a home health provider, such as a registered nurse, conducts a home visit to evaluate a newborn and provide newborn care education. This code is appropriate for situations where the provider performs a comprehensive assessment and education session during the visit. It should not be used for routine follow-up visits or visits that do not involve newborn care and assessment.

6. Documentation requirements

To support a claim for CPT 99502, the home health provider must document the following information:

• Details of the newborn’s health status and physical examination findings
• Documentation of vital signs taken during the visit
• Evidence of education provided on breastfeeding and lactation
• Instructions given to the patient on infant care and recognizing signs of illness
• Assessment of the home environment for safety
• Evaluation of the newborn for jaundice
• Any plans of care reviewed for the newborn
• Signature of the home health provider conducting the visit

7. Billing guidelines

When billing for CPT 99502, ensure that the home visit services are provided by a qualified home health provider, such as a registered nurse. The visit should include a comprehensive assessment and education session for newborn care and assessment. There are no specific guidelines regarding reporting CPT 99502 with other codes. However, it is important to follow any applicable payer guidelines and modifiers if required.

8. Historical information

CPT 99502 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 assess the health status of a newborn and provide education on breastfeeding and infant care.
2. A home health provider evaluating a newborn for jaundice and instructing the patient on recognizing signs of illness during a home visit.
3. A qualified professional conducting a home visit to assess the home environment for safety and educate the patient on infant care and recognizing signs of illness.
4. A registered nurse providing instructions on breastfeeding and lactation during a home visit for newborn care and assessment.
5. A home health provider conducting a physical examination of a newborn and evaluating the home environment for safety during a home visit.
6. A qualified professional educating the patient on recognizing signs of illness and providing instructions on infant care during a home visit for newborn care and assessment.
7. A registered nurse assessing the health status of a newborn and providing education on breastfeeding and lactation during a home visit.
8. A home health provider evaluating a newborn for jaundice and instructing the patient on infant care during a home visit for newborn care and assessment.
9. A qualified professional conducting a home visit to assess the home environment for safety and educate the patient on recognizing signs of illness and infant care.
10. A registered nurse providing instructions on breastfeeding and lactation and evaluating the home environment for safety during a home visit for newborn care and assessment.