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Family Practice Coding Alert

You Be the Coder:

Place of Service

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: I need clarification about which "place of service" indicator to use when reporting swing bed visits in the hospital. Some coders have advised me to use 31 for skilled-nursing facility, while others say I should report 21 for inpatient hospital. Which is correct?

Florida Subscriber

Answer: Swing beds are also called transitional-care units and are sections in a hospital assigned to patients who no longer need the high-level care provided on an inpatient basis. However, they still need  special care and must be near high-level-care facilities. National Medicare guidelines indicate that services provided in transitional-care units be identified with a 21 place-of-service indicator. Neither 31 nor 32 (nursing facility) is appropriate, but you should confirm this directive with local Medicare carriers.
Services provided to patients in transitional units are most often described by nursing facility codes, e.g., 99311-99313 (subsequent nursing facility care) or 99321-99333 (domiciliary or rest home). Again, individual carriers will provide specific guidance about coding these services.