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The CPT states that both Initial and Subsequent nursing facility care subcategories apply to new or established patients.Is it correct for a provider to bill an Initial Nursing Facility care code (99304 /99305 / 99306) the first time they personally render and E&M service in a nursing facility, regardless of the patient's admission date? The following article implies these 3 codes would ONLY be used within 30 days of the patient's admission to the facility, not when their care has been transferred to a new provider and their facility is unchanged. Please advise.
CMS MLM Matters Article MM4246 states CR4246: "The initial visit in both skilled nursing facilities (SNFs) and NFs is defined (per the Survey and Certification memorandum (S&C-04-08, dated November 13, 2003) as the initial comprehensive assessment visit during which the physician completes a thorough assessment, develops a plan of care, and writes or verifies admitting orders for the nursing facility resident." The same article adds: "[I]It must occur no later than 30 days after admission."[/I]
CMS MLM Matters Article MM4246 states CR4246: "The initial visit in both skilled nursing facilities (SNFs) and NFs is defined (per the Survey and Certification memorandum (S&C-04-08, dated November 13, 2003) as the initial comprehensive assessment visit during which the physician completes a thorough assessment, develops a plan of care, and writes or verifies admitting orders for the nursing facility resident." The same article adds: "[I]It must occur no later than 30 days after admission."[/I]