Wiki Nursing home visits

cmac

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my physician went to a medical director seminar and was told that if he was requested to see the patient, even if he's seen the patient already in 30 days (mcare will only pay for 1 visit every 30 days) that he can bill it out and get paid for it. i was always told that if it was for something different than his monthly visit you can bill it and get paid but we're getting denials. sometimes he sees the patient on lets say 5/23/08 and his monthly rounds were made 5/29/08. i get the 5/29/08 dicatation first and won't get the 5/23/08 until 6/1/08 or a later date. does anyone know how to bill more than 1 nursing home visit within 30 days and get paid if they were seen for 2 different reasons and if they were seen for the same reason?
 
What is your denial code? Our physicians and FNP's will visit pt's in the NH more frequently than the 30 day period when the pt's condition warrants. For the urgent visit I will use only the diagnosis for this date of service. I do not use the patient's current medical condition diagnosis unless they complicate or add to the current urgent condition.
 
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