O-12-910 Service Code Tipsheet with Unexpected Events
🎯 Purpose
Includes a description of the codes, buddy codes, discipline codes and code modifiers (ie. Non-Billable, Non-OASIS) and indicates which codes are available to the PointCare user to utilize in the Unexpected Event feature within specified visits for specific events.
Visit Type Codes
| Description | Code |
|---|---|
| Start of Care (Billable) | __00 |
| Evaluation–“Add-On” | __01 |
| Recert (Billable) | __02 |
| Recert (Non-Billable) | __03 |
| ROC w/RCT (in 5 day window) | __05 |
| Therapy Eval at RCT (in 5 day window) | __06 |
| Routine/Subsequent Visit + Supervision | __10 |
| Supervisory Visit Only (Non-Billable) | __10N |
| Routine/Subsequent Visit | __11 |
| Resumption of Care | __15 |
| Follow Up OASIS (SCIC) | __17 |
| Discharge from Agency with Visit | __18 |
| Discipline Discharge with Visit | __19 |
| Therapy 30 Day Reassessment Visit | __33 |
| Death at Home | __88 |
| Transfer to Inpatient Facility with Visit | __99 |
| Transfer to Inpatient Facility (Data Collection Only – NO VISIT MADE) | __44 |
| Discharge from Agency (Data Collection Only – NO VISIT MADE) | __66 |
Modifier Codes
| Description | Code |
|---|---|
| Non-OASIS (Para Only/Pediatric) | __X |
| Non-Billable | __N |
| Hourly Service Codes | __H |
| PRN Routine Visit | __PRN |
| Pediatric–RN | PDR__ |
| Pediatric–SN Routine/Subsequent | PDSN11 |
Profession Codes
| Discipline | Code |
|---|---|
| Registered Nurse | RN__ |
| Skilled Nurse (RN or LPN) | SN__ |
| Physical Therapist | PT__ |
| Physical Therapy Assistant | PA__ |
| Occupational Therapist | OT__ |
| Certified OT Assistant | CT__ |
| Speech Therapist | ST__ |
| Medical Social Worker | MS__ |
| Home Health Aide | HH__ |
| Homemaker | HMK__ |
Medical Treatment (“Buddy”) Codes
| Description | Code |
|---|---|
| Procedure Due | __90 |
| Lab Due | SN91 |
| Wound Measurements Due | __92 |
| INR Due | SN93 |
| Indwelling Catheter Change | SN94 |
| Injection Due | RN/SN95 |
| Flu Vaccine Due | SN96 |
| RN Infusion/Procedure/Lab/Dressing Change Due | RN96 |
| Comp/Skills Eval | __97 |
| Aide Orientation Phone Visit | __AOP |
| Medication Set-Up Due | SNMEDSET |
| Reminder to Give NOMNC | __–NOMNC |
| Reminder to Give HHCCN | __–HHCN |
| Telephone Follow-Up Call | SN-TELE |
| Interpreter Needed | __–INTERP |
⚠️ Unexpected Events Logic
Unexpected Events: Allows PointCare Clinician to change the Service Code from the device within a set of designated alternative service codes. Only available for specific service codes.
Service Codes
| Visit Type | Code |
|---|---|
| Subsequent NURSING | __11, __10 |
| Discipline Discharge | __19 |
| RCT | __02 |
| Follow Up | __17 |
| Therapy Reassessment | __33 |
| Discharge | __18 |
| ROC | __15 |
| PRN | __PRN |
| ROC with RCT | __05 |
Unexpected Events
| Event Description | Code |
|---|---|
| Resumption of Care | __15 |
| Follow Up / SCIC (Significant Change in Condition) | __17 |
| Transfer to Inpatient Facility (WITH A VISIT) | __99 |
| Death at Home | __88 |
| Subsequent Visit | __11 |
Example: On a Discipline Discharge 19, the clinician can use the Unexpected Event feature to change the visit from the device to a Subsequent Visit 11 if they determine client will require ongoing services.
EXCEPTION for Therapy Reassessments: On a Subsequent Therapy Visit Only PT/OT/ST11 or 10, the therapist is able to select the Unexpected Event titled “Subsequent” to change the visit to a “REASSESSMENT” __33.
Subsequent Therapy Only ( PT/OT/ST11 and PT/OT/ST10 )
| Event Description | Code |
|---|---|
| Resumption of Care | __15 |
| Follow Up / SCIC (Significant Change in Condition) | __17 |
| Transfer to Inpatient Facility (WITH A VISIT) | __99 |
| Death at Home | __88 |
| Subsequent Visit (NOTE- Title indicates Subsequent, but on these visit types it will change to a Reassessment) | __33 |
📅 Effective: 05/03/2024  |  🛠️ Revised: 09/09/2024  |  ✅ Approved by: JS