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Wiki Correct CPT

Messages
29
Location
New Lenox, IL
Best answers
0
We have billed 99232 with place of service 21 for a patient in an acute rehab wing of a hospital. Medicare denied the claim stating that we should have billed with 99309 and 31 which is the nursing home code. This is a wing of the hospital and not a stand alone building. Any suggestions?
 
It does not matter if it's a wing of the same building, or a stand alone building. What matters is how the patient is registered. For example, if the patient is physically in the ER, but orders/decision to admit are already done, then the POS is inpatient 21, not 23 emergency room.

If patient is registered to Part A SNF, then POS 31 would be correct.
 
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