tci Medicare Compliance & Reimbursement - 2014 Issue 11

Nursing Facility Visits: Will Documentation of Your Doctor's SNF Visits Stand Up To Close Scrutiny?

Review of nursing facility care claims data leads to astounding findings. You could find your doctor’s SNF visits under the microscope soon. E/M code use has been drawing suspicion for quite some time. Now NGS Medicare is joining the Centers for Medicare and Medicaid Services (CMS), in going over subsequent nursing facility visit codes 99309-99310 with a fine-toothed comb. NGS, a Part B payer, announced on May 7 that it had recently reviewed claims for these codes and found that its providers in Connecticut, New York, and Massachusetts appeared to collect for a higher percentage of these visits...

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