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Need Help with Coding

Lina Posted Thu 01st of June, 2017 16:13:32 PM
Hi, our doctor saw patients in the nursibg fasility and had following procedures(such as 20553, 94010, 92520, 92512, 94620 and 97140) done on several patients, but Im not sure if we are allowed to bill above mentioned CPT codes under place of service 32. PS the doctor DUO board certified and pain managment is one of them. Thank you in advanced
Lina Posted Fri 02nd of June, 2017 11:33:04 AM
CAN SOMEONE PLEASE HELP ME, Hi, our doctor saw patients in the nursibg fasility and had following procedures(such as 20553, 94010, 92520, 92512, 94620 and 97140) done on several patients, but Im not sure if we are allowed to bill above mentioned CPT codes under place of service 32. PS the doctor DUO board certified and pain managment is one of them. Thank you in advanced
SuperCoder Answered Fri 02nd of June, 2017 14:16:54 PM

Hi,

The exact answer would depend upon certain specific factors. To determine the correct POS for a particular patient, we must know how the nursing facility classifies that patient, i.e., as SNF or long-term. We can use the CPT nursing facility codes under POS 32 only if the patient is not having Part A SNF benefits or if he is in a NF. Also, one can only bill under POS 32 (NF) if the patient is given skilled nursing care and services for the rehabilitation of injuries, disabilities, or sickness, or if the patient receives the health care services on a regular basis, above the level of custodial care to individuals who are not mentally retarded. 

Thank you.

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