Wiki 99306

[finners1]

We have a pt who has been in a SNF since 1-2013, pt recently needed to admitted to hospital and was then discharged back to nursing home. Can you bill a 99306?

 

[Cynthia Hughes]

Assuming the requirements for reporting the code are met, readmissions are treated the same as initial admissions. This is indirectly stated in CPT, "When the patient is admitted to the nursing facility in the course of an encounter in another site of service (eg, hospital emergency department, office), all evaluation and management services provided by that physician in conjunction with that admission are considered part of the initial nursing facility care when performed on the same date as the admission or readmission." (The hospital discharge services can be separately reported as indicated in the next paragraph of CPT.) CMS also states for Medicare patients, "A readmission to a SNF or NF shall have the same payment policy requirements as an initial admission in both the SNF and NF settings."