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SNF patient seen in drs office.

  1. Default SNF patient seen in drs office.
    Medical Coding Books
    We have a patient that was brought to the office for an out patient visit 99213, pos 11. The insurance is denying stating we used the wrong pos. Do we keep the 99213 and use the SNF location? I am confused, any help will be appreciated.
    dkmorgan3

  2. #2
    Location
    Columbia, MO
    Posts
    12,910
    Default
    You must use the POS of where the patient is registered. So yes you use the nursing facility POS with office E&M.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    thanks so much for your reply. Do I use the office visit 99213 with the SNF pos, or do I need to use 99304?

  4. #4
    Location
    Columbia, MO
    Posts
    12,910
    Default
    If seen in the office you use office levels, you can look this up on the Medicare website under POS guidelines.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Default
    there is another possible scenario... sometimes you have to append a modifier of GV or GW depending on whether the patient is or is not being treated in your office for a condition related to hospice.... your denial code should point you in the appropriate direction.
    Teresa Kelley, CPC
    Detroit, MI AAPC Chapter member

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