tci General Surgery Coding Alert - 2011 Issue 6

Reader Questions: 99304-99306 Require Three Key Components

Question: How do I bill if our surgeon went to the nursing home to see a Medicare patient for a consultation, but did not meet all three requirements to charge an initial nursing facility visit. Would I use 99307?Texas SubscriberAnswer: The codes for initial nursing home visits are 99304-99306 (Initial nursing facility care, per day, for the evaluation and management of a patient ...). However, these codes do require that the physician meet all three key components. Since the surgeon did not meet the three components, you cannot bill these codes.Under these circumstances, some Medicare payers may...

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