tci Part B Insider - 2003 Issue 6

CODING: Don't Overbill For Stable Nursing Home Patients

When the doctor drops by the nursing home, it barely seems worthwhile to bill the lowest-paying codes for that crosstown drive. But be careful about billing the big-ticket codes for a flying visit to a patient who's not taking a turn for the worse. Physician billers should be aware of the benefits and pitfalls of using high-reimbursement codes, for example on the ascending scale from 99311 to 99313 for nursing home services, according to Jean Ryan-Niemackl, LPN, CPC, a content analyst in the Quantim Health Information Management division of QuadraMed. Medicare imposes a few factors for those codes, Ryan-Niemacki...

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