Documentation of Medical Necessity of the Home Visit; and Physician Management Associated with Superficial Radiation Treatment - Revised

MLN Matters Number: MM11273
Related CR Release Date: May 24, 2019
Related CR Transmittal Number: R4309CP
Related Change Request (CR) Number: 11273
Effective Date: January 1, 2019
Implementation Date: August 27, 2019

Note: CMS revised this article on July 25, 2019, to reflect the reissued CR11273 dated July 25. In the article, CMS revised the CR release date, transmittal number, and the web address of the CR. All other information remains the same.

CR11273 removes the requirement that the medical record show a home visit was medically necessary instead of an office or outpatient visit. Also, the Centers for Medicare & Medicaid Services (CMS) added a new section to chapter 12 of the Medicare Claims Processing Manual regarding Evaluation and Management (E/M) codes that you may bill with superficial radiation treatment. Make your billing staff aware of these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11273.

Last Updated Jul 26, 2019