tci General Surgery Coding Alert - 2003 Issue 1

Reader Question: Match E/M and Place-of-Service Codes

Question: One of my physicians was asked to see a patient in a nursing home. We reported 99244 with a place of service 32. Medicare denied the claim. Any suggestions? Arkansas SubscriberAnswer: The carrier is correct to reject the claim. The CPT code and place of service do not match. CPT specifically notes that office or other outpatient consultation codes (99241-99245), including 99244 (Office consultation for a new or established patient ...), "are used to report consultations provided in the physicians office or in an outpatient or other ambulatory facility, including hospital observation services, home services, domiciliary, rest home...

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