Wiki Auditing nursing facility coding

[efuhrmann]

I am performing an audit of a provider's coding of nursing home visits and would like any input on the subject.

 

[cdcpc]

Some of our physicians visit the nursing homes on a monthly basis to check up on how the patients are doing and reccommend care as needed. I audit nursing home visits in a similar way to office visits. Choosing a nursing home code is based off the same components as office visits (history exam and medical decision making). I use the same audit tool that I use for office visits. I use the tool to find out what level history, exam and medical decision making is, then I base the code off of what the audit shows.
Initial nursing facility visits are coded with 99304, 99305 or 99306 as long as all three components are met. Subsequent nursing home visits are coded with 99307, 99308, 99309, or 99310 as long as 2 out of the three components are met.
I'm not sure if this is the kind of information you were looking for, but I thought it was worth a shot. I'm hoping to see what others say to this.