N.J. Admin. Code § 10:54-4.5

Current through Register Vol. 56, No. 24, December 18, 2024

Section 10:54-4.5 - Use of HCPCS codes for established patient visits

(a) This rule applies to office, inpatient or outpatient services to established patients (excluding preventive health care for patients through 20 years of age).

(b) "Routine visit" or "follow-up visit" means the care and treatment by a physician, which includes those procedures ordinarily performed during a health care visit, which is dependent upon the setting and the physician's discipline. The setting may be an office, hospital, nursing facility or residential health care facility.

1. In order to receive reimbursement for a routine visit or follow-up visit, the documentation requirements set forth in N.J.A.C. 10:54-2.3 shall be met, regardless of where the examination was performed.

N.J. Admin. Code § 10:54-4.5

Recodified from N.J.A.C. 10:54-4.4 by R.1998 d.154, effective 2/27/1998 (operative March 1, 1998; to expire August 31, 1998).
See: 30 New Jersey Register 1060(a).
Former N.J.A.C. 10:54-4.5, Use of HCPCS codes for home visits and house calls, recodified to N.J.A.C. 10:54-4.6.
Adopted concurrent proposal, R.1998 d.487, effective 8/28/1998.
See: 30 New Jersey Register 1060(a), 30 New Jersey Register 3519(a).
Readopted the provisions of R.1998 d.154 without change.