Podiatry Coding & Billing Alert

Question: Is 99307 the correct code for a nursing home consult? Our podiatrist has seen the patient in the office before but that was several months ago.

Nevada Subscriber

Answer: Codes 99304-99306 (Initial nursing facility care, per day, for the evaluation and management of a patient ...) apply to initial nursing facility care, so you would choose from those codes based on the level of care. Code 99307 (Subsequent nursing facility care, per day, for the evaluation and management of a patient ...) is the lowest-level code for subsequent care in a nursing facility, so wouldn't apply to a first-time consult.

Initial code caution: Medicare does not reimburse 99304 for some physicians, including podiatrists. If your carrier doesn't allow 99304 for podiatrists you'll need to determine the most appropriate alternative before submitting your claim.