How To Use CPT Code 99509

CPT 99509 describes the home visit services provided by a healthcare professional to assist patients with activities of daily living (ADLs) and personal care. 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 99509?

CPT 99509 can be used to describe the home visit services provided by a healthcare professional to assist patients with activities of daily living (ADLs) and personal care. This code is used when a registered nurse or non-nursing practitioner visits a patient’s home to provide help with ADLs, such as bathing, dressing, grooming, eating, using the bathroom, walking, and transferring from one location to another.

2. Official Description

The official description of CPT code 99509 is: ‘Home visit for assistance with activities of daily living and personal care.’

3. Procedure

1. A healthcare professional, such as a registered nurse or non-nursing practitioner, visits the patient’s home.
2. The healthcare professional assists the patient with activities of daily living (ADLs), such as bathing, dressing, grooming, eating, using the bathroom, walking, and transferring.
3. The assistance provided is based on a care plan established with the physician, patient, and family members.
4. The healthcare professional may also provide personal care services, such as medication management or wound care, if necessary.
5. The visit may last for a specified period of time, depending on the patient’s needs and the care plan.
6. Additional visits may be scheduled as needed to ensure the patient’s ongoing assistance with ADLs and personal care.

4. Qualifying circumstances

Patients eligible to receive CPT 99509 services are those who require assistance with activities of daily living (ADLs) and personal care. This may include individuals who are elderly, disabled, or recovering from an illness or injury. The services are provided by a healthcare professional, such as a registered nurse or non-nursing practitioner, who visits the patient’s home to provide the necessary assistance.

5. When to use CPT code 99509

CPT code 99509 should be used when a healthcare professional visits a patient’s home to provide assistance with activities of daily living (ADLs) and personal care. This code is appropriate for situations where the patient requires ongoing assistance with ADLs and personal care, and the services are provided in the patient’s home.

6. Documentation requirements

To support a claim for CPT 99509, the healthcare professional must document the following information:

• Patient’s need for assistance with activities of daily living (ADLs) and personal care
• Care plan established with the physician, patient, and family members
• Date and duration of the home visit
• Specific ADLs and personal care services provided
• Progress made by the patient and any additional visits scheduled
• Signature of the healthcare professional providing the service

7. Billing guidelines

When billing for CPT 99509, ensure that the services are provided by a healthcare professional, such as a registered nurse or non-nursing practitioner, and that the visit takes place in the patient’s home. There are no specific guidelines regarding reporting CPT 99509 with other codes. However, it is important to accurately document the services provided and ensure that they are medically necessary.

8. Historical information

CPT 99509 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 visiting an elderly patient’s home to assist with bathing, dressing, and medication management.
2. A non-nursing practitioner providing personal care services, such as wound care and mobility assistance, to a patient recovering from surgery.
3. A healthcare professional assisting a disabled individual with eating, using the bathroom, and transferring from a wheelchair to the bed.
4. A registered nurse visiting a patient with a chronic illness to provide assistance with grooming, medication management, and walking.
5. A non-nursing practitioner helping an elderly patient with dressing, eating, and using the bathroom during a home visit.
6. A healthcare professional providing assistance with activities of daily living (ADLs) and personal care to a patient with a temporary disability.
7. A registered nurse visiting a patient’s home to provide assistance with bathing, dressing, and mobility.
8. A non-nursing practitioner assisting a patient with eating, using the bathroom, and transferring during a home visit.
9. A healthcare professional providing personal care services, such as medication management and wound care, to a patient with a chronic illness.
10. A registered nurse visiting an elderly patient’s home to assist with grooming, medication management, and walking.