tci Medicare Compliance & Reimbursement - 2011 Issue 7

Reader Questions: Know How to Report Nursing Home Visits

Question: How do I bill if our physician went to the nursing home to see Medicare patients for consultations, but did not meet all three requirements to charge an initial nursing facility visit. Would I use 99307?Answer: 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 all three key components be met. Since the physician did not meet the three components, you cannot bill these codes. Under these circumstances some Medicare carriers may require unlisted code 99499...

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