tci Part B Insider - 2014 Issue 19

Nursing Facility Visits: This Payer Is Scrutinizing Nursing Facility Visits Carefully

Codes 99309-99310 are under the microscope for NGS Medicare practices. If you think CMS is only watching your E/M codes when it comes to the office or hospital, think again. One MAC recently reviewed nursing facility care claims data and was stunned at the findings. NGS Medicare, a Part B payer, announced on May 7 that it had recently reviewed claims for subsequent nursing facility visit codes 99309-99310, and found that its providers in Connecticut, New York and Massachusetts appeared to collect for a higher percentage of these visits than expected. Based on the outcome of the review, NGS...

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