snf

  1. J

    Question SNF primary dx for SDH

    Hello! Any help and input for this situation is very much appreciated! I have a new resident coming in from a long hospital stay (admitted 2/14/22). She was initially diagnosed in the hospital with acute on chronic subdural hemorrhage and multiple facial fractures resulting from a fall off of a...
  2. J

    Question SNF primary dx selection

    Hello - I am having a hard time determining an appropriate primary diagnosis for a new admission for short term rehab to a SNF. Patient presented to ER after being found down after an indeterminant amount of time. She was found to have had a small, suspected cardioembolic, stroke with...
  3. D

    Question Psych SNF and Inpatient codes

    Hi All, I could use some insight. Our physicians do rounds at SNF facilities and do some Inpatient rounds and hospitals as well. They are not doing psychotherapy sessions, they are reviewing the whole chart and initially evaluating to see if patient is depressed or having manic episodes, etc...
  4. D

    Question Psych codes in SNF and Inpatient

    Hi All, I could use some insight. Our physicians do rounds at SNF facilities and do some Inpatient rounds and hospitals as well. They are not doing psychotherapy sessions, they are reviewing the whole chart and initially evaluating to see if patient is depressed or having manic episodes, etc...
  5. W

    Question E/M coding for Skilled Nursing Facility

    It was brought to my attention that medical evaluation and management CPT Codes (9920* - 9921*) reported by our Optometrists and Ophthalmologists could be rejected by CMS when billed in a SNF-Skilled Nursing Facility-setting (POS 31, 32, etc.). I have read conflicting info indicating Optometry...
  6. A

    Ancillary Charges for Nursing Homes

    Hi guys, I appreciate any legit links, data, etc... I have been billing for a nursing home for about 8 months. I had no training (other than my many years knowledge of general medical billing, and coding experience). I have a handle on the SNF claims. I completely understand the...
  7. S

    Question SNF vs Long Term Care

    One of the providers I bill for currently sees patients in a nursing home. He is thinking of switching floors and if so, would be seeing long term care patients instead. I currently bill using CPT codes 99306-99316. I know Medicare A has different coverage for long term vs short term...
  8. D

    Obtaining Correct POS From Facility SNF/Assisted

    My Dr does rounds at a local what I thought was a SNF, I billed 99305 with POS 31 the address of the facility and the referring physician but still recieved denials from Medicare. Do I continue to try and get ahold of someone to ask at the facility or do I call and ask Medicare?
  9. G

    SNF Form Letter Sample

    Hi, guys! I was looking for the SNF form letter sample that they mentioned on page 25 of the December 2018 issue but all it says is that it's in the Resource center. I am not seeing where they posted the sample so I may be in the wrong area. Has anyone seen it?
  10. B

    SNF Therapy Audit help! Level 3 dispute!

    This is going to be long, and I apologize. I need some help from anyone with SNF experience, especially with billing of CPT codes. Here goes.... The first denial came back stating: "The 5 day assessment, ARD 8/3/17 pays for 8/1-8/3/17 and the 14 day/COT assessment ARD 8/10/2017 pays for...
  11. B

    Coding from HPI for LTC

    Hello All, I work in LTC and I got a notification from one of my MDS nurses that they had added a dx of Dementia for a resident, but I did not have it on my diagnosis sheet for that particular resident. I went through all the documentation and could not find a dx or dx code of Dementia for said...
  12. B

    Skilled Nursing Facility

    I have a question regarding coding for ICD-10 at a SNF. I'm currently using an OPTUM 360 book purchased before I was hired. I can get a discount for the 2018 ICD-10-CM Expert for Providers and Facilities with my AAPC membership. My question is, are they basically the same book? This is my first...
  13. V

    Psychologist in SNF

    Fl Medicare billing... if the patient is in skilled care will a psychologist be paid by Medicare for the mental health visit? I see physicians will but my understanding is they are not considered physicians and will not be paid if the patient is in skilled care. Any experience with this?
  14. H

    Office Visit & Skilled Nursing Facility

    I am looking for insight - I work for a healthcare system which includes many different primary care and specialty services in the office setting. Some of our offices see patients who happen to be in a skilled nursing facility. The patients are being brought from the SNF to the provider's office...
  15. D

    Taking over billing for a SNF - how do I make sure I'm doing everything correctly?

    Hello, My co in process of taking over billing for a Skilled Nursing Facility. However, this will be the 1st SNF our company handles billing for & even though we did a lot of research into all the guidelines & etc all over the internet, including CMS, we are worried about our compliance...
  16. C

    Skilled Nursing Facility

    We treated a patient who was enrolled in a SNF with Procrit. They are now requesting money back. Is there a modifier I can use? Or how can we be reimbursed for this procedure?
  17. J

    Patient not present

    We have a doctor that went over just the results of lab work with a patient's family member. This patient has dementia and it is difficult to get the patient to the office, patient is not in a SNF and not on hospice. I was wondering how we would code it. Please help.
  18. J

    Skilled nursing home initial visit

    A gentleman who is currently a skilled nursing home resident recently decided to change his primary care physician to our doctor. It is not a new SNF admission although the doctor has never seen this patient. Would the first visit be an initial nursing facility visit or a subsequent?
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