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

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains recent Medicare contractor review activity focused on subsequent nursing facility visit claims and discusses the documentation themes that are drawing attention. It is useful for coders, billers, auditors, and clinicians who report or review nursing facility evaluation and management services and want a broad understanding of the compliance issues, time-based reporting concepts, and record-request follow-up process described in the article.

Why This Topic Matters

Claims for nursing facility evaluation and management services can be subject to focused review, so understanding the documentation and time-keeping topics discussed here may help practices prepare for scrutiny and respond appropriately to record requests.

What You Will Learn

  • What kind of nursing facility E/M claims are being reviewed
  • What documentation themes are associated with higher-level subsequent nursing facility visits
  • How time-based reporting for nursing facility visits is discussed in the article
  • What happens when records are requested during a payer review

Who Should Read This

  • Medical coders
  • Billing staff
  • Compliance auditors
  • Physicians
  • Nurse practitioners
  • Practice managers

Codes Discussed

  • CPT: 99309
  • CPT: 99310

Code Ranges Discussed

  • CPT: 99309-99310

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