Wiki Hospital E&M codes for pos 61

[medipro5]

Hi, does anyone know what E&M codes are appropriate for Comprensive Inpatient rehab? We used hospital inpatient codes and Medicare is stating we should've used Snf codes? dont know if I should fight it or recode. I appreciate your input!

Debi

 

[mhstrauss]

Hi, does anyone know what E&M codes are appropriate for Comprensive Inpatient rehab? We used hospital inpatient codes and Medicare is stating we should've used Snf codes? dont know if I should fight it or recode. I appreciate your input!

Debi

Our physiatrists see patients in inpatient rehab units; we file using POS 61 and the inpatient codes 99221-99223; 99231-99233; 99251-99255. Never had problems with Medicare (Novitas) or commercial payers doing it this way. Have you filed claims for this same POS before? If yes, any problems? Maybe check with the facility and see how they are registered with Medicare?

 

[medipro5]

Meagan thank you. That's what I thought. I will fight it. Medicare NY has enlisted a private audit service to review these claims, but I've always gotten paid in the past. I appreciate your feedback.

Debi