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Coding Nursing Home Visits

Alan Posted Thu 27th of December, 2012 20:55:08 PM

Our doctors were consulted to a nursing home. They have never gone before. Not sure what codes to use. When I looked in the book the codes 99304-99310 for nursing faciltiy visits state for admitting physician, initial care and subsequent care. Since we are specialists not sure if we use these codes as well? Any help would be appreciated.

SuperCoder Answered Fri 04th of January, 2013 20:10:00 PM

Specialists may report the nursing facility codes you mention. You also want to be sure to review the place of service code. Check out Medicare Claims Processing Manual, Chapter 12, Section 30.6.13 at http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf.

It explains thing like the use of modifier AI to distinguish the principal physician from other specialty care physicians:
“The principal physician of record must append the modifier “-AI”, (Principal Physician of Record), to the initial nursing facility care code. This modifier will identify the physician who oversees the patient’s care from other physicians who may be furnishing specialty care. All other physicians or qualified NPPs who perform an initial evaluation in the NF or SNF may bill the initial nursing facility care code.”

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