Wiki 36589 denial nursing facility

[Limbanidd2012@gmail.com]

When we billed 36589 CPT code with POS31 and POS32, we get a denial.

Please provide any guidelines or suggestions for the same. So we get payment.

 

[haraml7]

Who is the carrier, and was there any other procedure codes billed with this code?

 

[Limbanidd2012@gmail.com]

For Medicaid carrier. We are billing with SNF and ALF facility E&M code(99304-99310)(99324-99337).

 

[haraml7]

POS-31 SNF=A facility which primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital . Was this patient admitted to the nursing facility the same day the procedure was performed?- The CMS guidelines explain this a little better for coding purposes if you want to look into that.
POS-32 Nursing Facility=A facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care services above the level of custodial care to other than individuals with intellectual disabilities. Does this place of service has an "operating suite"

 

[Limbanidd2012@gmail.com]

Thanks for your response.
Can you send me any guideline or link if you have so i will explain more better to my physicians.

 

[haraml7]

Thanks for your response.
Can you send me any guideline or link if you have so i will explain more better to my physicians.

I pulled the guidelines from the CPT book, where they describe each POS. Its in the front of the CPT book. Also CPT guidelines for nursing facilities explains this as well.