How To Use CPT Code 99504

CPT 99504 describes the home visit for mechanical ventilation care provided by a licensed respiratory therapist or other non-physician provider. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 99504?

CPT 99504 can be used to describe the home visit services provided by a licensed respiratory therapist or other non-physician provider for mechanical ventilation care. This code is used when the provider checks the ventilator, educates the patient and family on its use and settings, and may also address other respiratory needs during the visit, such as tracheostomy care or respiratory therapy.

2. Official Description

The official description of CPT code 99504 is: ‘Home visit for mechanical ventilation care.’ There are no additional notes available for this code.

3. Procedure

1. The licensed respiratory therapist or non-physician provider visits the patient’s home.
2. They check the ventilator to ensure it is functioning properly.
3. The provider educates the patient and their family on how to use and adjust the ventilator settings.
4. During the visit, the provider may also address other respiratory needs, such as tracheostomy care or respiratory therapy.

4. Qualifying circumstances

CPT 99504 is used for patients who require mechanical ventilation care in their home. The provider must be a licensed respiratory therapist or other non-physician provider. The visit must involve checking the ventilator, educating the patient and family on its use and settings, and may include addressing other respiratory needs.

5. When to use CPT code 99504

CPT code 99504 should be used when a licensed respiratory therapist or non-physician provider performs a home visit for mechanical ventilation care. It should not be used for other types of home visits or services unrelated to mechanical ventilation care.

6. Documentation requirements

To support a claim for CPT 99504, the provider must document the following information:

• Confirmation that the patient requires mechanical ventilation care
• Details of the ventilator checked and any adjustments made
• Evidence of education provided to the patient and family on ventilator use and settings
• Documentation of any other respiratory needs addressed during the visit
• Date and duration of the home visit
• Signature of the licensed respiratory therapist or non-physician provider

7. Billing guidelines

When billing for CPT 99504, ensure that the provider is a licensed respiratory therapist or non-physician provider. The visit must involve mechanical ventilation care in the patient’s home. There are no specific guidelines regarding reporting CPT 99504 with other codes.

8. Historical information

CPT 99504 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates or changes to the code since its addition.

9. Examples

1. A licensed respiratory therapist visiting a patient’s home to check and adjust the ventilator settings for a patient on mechanical ventilation.
2. A non-physician provider providing education to a patient and their family on how to use and maintain a ventilator during a home visit.
3. A licensed respiratory therapist addressing tracheostomy care and providing respiratory therapy during a home visit for a patient on mechanical ventilation.
4. A non-physician provider conducting a home visit to check the ventilator and provide additional respiratory therapy for a patient with respiratory needs.
5. A licensed respiratory therapist performing a home visit to educate a patient and their family on ventilator use and settings, as well as providing respiratory therapy.
6. A non-physician provider visiting a patient’s home to check the ventilator and provide respiratory assistance, including tracheostomy care.
7. A licensed respiratory therapist conducting a home visit to set up and manage the ventilator for a patient on mechanical ventilation.
8. A non-physician provider providing respiratory therapy during a home visit for a patient on mechanical ventilation.
9. A licensed respiratory therapist visiting a patient’s home to adjust the ventilator settings and provide additional respiratory therapy.
10. A non-physician provider performing a home visit to set up and manage the ventilator, as well as provide respiratory therapy for a patient on mechanical ventilation.