Wiki Correct CPT

[tilquist3@comcast.net]

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?

 

[csperoni]

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.