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Long Term Acute Care (LTACH) billing

Don Posted Fri 06th of May, 2016 16:20:15 PM
Long Term Acute Care (LTACH) billing: What procedures should I use when I bill physician services? What is the place of service?
SuperCoder Answered Mon 09th of May, 2016 05:12:34 AM
Hi, LTAC has 2 types of sevices: Level 1 Services - Long-term acute-care (LTAC) services provided to a client who requires eight or more hours of direct skilled nursing care per day and the client's medical needs cannot be met at a lower level of caredue to clinical complexity. Level 1 services include one ((or both)) of the following: • Ventilator weaning care; or • Care for a client who has:¾ Chronic open wounds that require on-site wound care specialty services and daily assessments and/or interventions; and ¾ At least one comorbid condition (such as chronic renal failure requiring hemodialysis). Level 2 services - Long-term acute-care (LTAC) services provided to a client who requires four or more hours of direct skilled nursing care per day, and the clients'medical needs cannot be met at a lower level of care due to clinical complexity. Level 2 services include at least one of the following: • Ventilator care for a client who is ventilator-dependent and is not weanable,and has complex medical needs; or • Care for a client who has a tracheostomy; and ¾ Requires frequent respiratory therapy services for complex airway management and has the potential for decannulation; and ¾ Has at least one comorbid condition (such as quadriplegia.) The most frequently consulted physicians are from specialities like pulmonary, GI, nephrology, infectious diseases. As for POS, as per CMS, POS 12(Client's Residence),13(Assisted Living Facility),32(Nursing facility),31(Skilled Nursing facility),99 (Other).These codes are to be used while filling CMS-1500 Form. Hope this Helps. Thanks.
Don Posted Tue 10th of May, 2016 12:16:25 PM
What are the CPTs that are associated.
SuperCoder Answered Thu 12th of May, 2016 02:21:38 AM
Hi, Please refer to following document by AMA for help to CPT codes. http://www.hca.wa.gov/medicaid/billing/documents/guides/ltac_bieff11072008-05082010.pdf Also, we cannot provide CPT codes unless we get to know what services are rendered to the patient during that visit. Hope that helps! Thanks

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