modifier for E&M w/SNF resident?

Karen A.

Networker
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40
Location
Grants Pass
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We have a medicare pt, we did not know she was in skilled nursing facility in a covered part A stay. This patient was brought to our "professional office/non facility". We saw her for 2 E&M visits and an endometrial biopsy. We billed medicare part B, they paid & have recouped the payment. I have been unable to find any information on billing office visits/procedures in such a way that medicare will cover them when done in our office. Do we bill the SNF directly without billing medicare? Any advice will be greatly appreicated. This is a very rare occurance for our OB/GYN group.
 

lcarbaugh

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5
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if you go onto cms's website there is a listing for snf consolidated billing which shows which codes medicare will pay and what needs to be sent to snf. for the codes that are not covered by medicare you do bill snf directly. e/m codes are generally covered by medicare so i'm not sure why the recouped payment on those.
 
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