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Nursing Home

Brenda Posted Fri 04th of February, 2011 04:14:16 AM

My physician (Podiatrist) is considering going to the nursing home a few times a month to treat the patients w/foot and ankle issues. These pt's have come to the office in the past but it is quite an undertaking for the Nursing Home to transport them so they have asked him if he would consider coming to the Facility to treat them.

Is there anything, red flag, I need to know about billing for e/m and or any procedures he may do? I am told that the previous biller told him he could not bill for his services but I do not believe this to be true.

SuperCoder Answered Fri 04th of February, 2011 21:47:24 PM

This needs some research...will be coming up with an answer ASAP.

Michael Answered Mon 07th of February, 2011 22:34:57 PM

I bill for a group of clinititions who also go to nursing homes and provide wound care. I was wondering if there is a good source of info on would care and nursing homes, such as, if a patient is re-hospitalized can the clinition code new patient visit, 99305 upon returning to the nursing facility. Sometime Medicare (Indiana) will say the procedure was not medically necessary. Can anyone say what Medicare is looking for to make that determination? Appreciate any help.

SuperCoder Answered Wed 09th of February, 2011 17:50:51 PM

Coding 99304-99306(as per documentation) is based on assessment done when a patient is admitted to a nursing home. Podiatrists can't admit and so can't bill this code. So,it is my understanding that a podiatrist would use 99307.

So,a podiatrist is limited to subsequent nursing facility visit codes (99307 - 99310) regardless of whether the patient is new or established to the podiatrist rendering the service.

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