2025 CPT code 99500
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Medicine Services and Procedures - Home Visit Services Home Health Procedures and Services Feed
Home visit for prenatal monitoring and assessment, including fetal heart rate, non-stress test, uterine monitoring, and gestational diabetes monitoring.
Modifiers may apply depending on the circumstances of the visit.For instance, modifier 25 might be used to indicate a significant, separately identifiable E/M service.Consult the official CPT manual for details on appropriate modifier usage.
Medical necessity is established by the patient's condition.The need for home visits for prenatal monitoring and assessment is typically determined by the patient's medical history, such as high-risk pregnancies, gestational diabetes, hypertension, or other medical complications that require frequent monitoring and close observation. The frequency of visits will be determined by the patient's clinical condition and the need for frequent monitoring.
The clinical responsibility lies with the home health provider (e.g., registered nurse) who performs the assessments and monitoring. This includes interpreting fetal heart rate patterns, uterine activity, and blood glucose levels to assess maternal and fetal well-being and communicate findings to the primary care physician or other supervising physician.
In simple words: A nurse or other healthcare professional visits a pregnant woman at home to check on her and her baby's health. This includes listening to the baby's heartbeat, monitoring the baby's movements and the mother's contractions, and checking the mother's blood sugar levels to manage gestational diabetes.
This CPT code (99500) represents a home visit conducted by a qualified healthcare professional for prenatal monitoring and assessment of a pregnant patient with pregnancy complications.The visit includes monitoring fetal heart rate (using methods such as external monitoring with a stethoscope or electronic fetal monitoring with non-stress tests and uterine activity monitoring), assessing uterine activity, and monitoring for gestational diabetes using blood glucose measurements. This comprehensive assessment aims to evaluate both maternal and fetal well-being.
Example 1: A pregnant woman with a history of gestational diabetes in a previous pregnancy is experiencing nausea and vomiting at 28 weeks gestation. A home health nurse visits to monitor fetal heart rate, assess uterine activity using a non-stress test, and perform a blood glucose check to manage gestational diabetes., A pregnant woman with hypertension is being monitored at home. A nurse visits to perform fetal heart rate monitoring using an external Doppler, assess blood pressure, and educate the patient on managing her condition and identifying warning signs., A pregnant patient with preeclampsia is under strict monitoring. The home healthcare professional uses electronic fetal monitoring to assess both fetal heart rate and uterine contractions, documenting any irregularities and reporting this to the managing physician.
Thorough documentation is required, including the patient's vital signs, fetal heart rate patterns (including baseline, variability, accelerations, decelerations), uterine activity (frequency, duration, intensity of contractions), blood glucose levels, and any other relevant observations.A detailed assessment of the patient's condition and the rationale for the home visit should be included.The provider's signature and credentials are also essential.
** This code is used for comprehensive prenatal monitoring and assessment in the home setting.The services rendered are usually provided by a registered nurse or other qualified home healthcare professional. It's crucial to document all services performed thoroughly to ensure accurate billing and reimbursement.
- Revenue Code: M5D (SPECIALIST - OTHER)
- RVU: This information is not available in the provided text and requires accessing additional resources such as the AMA CPT codebook or a medical billing software with up-to-date RVU data. RVUs vary by location and payer.
- Global Days: The global period for this code is not explicitly defined in the provided text.Further research is needed to determine the global period, which could vary depending on the payer and the specific services provided.
- Payment Status: Active
- Modifier TC rule: The TC modifier is not typically applicable to this code as it represents the entire service.
- Fee Schedule: Historical fee schedule data is not available in the provided information. Consult the AMA CPT codebook or a medical billing software for historic fee information.Keep in mind that fee schedules vary by payer and location.
- Specialties:Obstetrics and Gynecology, Family Medicine, Home Health Nursing
- Place of Service:Home, Assisted Living Facility, Group Home, Custodial Care Facility