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Nursing Home - Need Inputs

  1. #11
    Richardson, Texas
    Medical Coding Books
    The psych consult needs to be reported with inpatient consultation codes (99251-99255), if the documentation criteria is met. (If consult criteria is not met, use the nursing facility subsequent visit codes.) Nursing facility stays are inpatient--not outpatient services. The subsequent nursing facility visits should be reported using CPT codes 99307 - 99310). Be sure to report with the nursing facility POS 31 or 32.

    If you still receive a denial, check to see if another provider saw the patient on the same DOS and used the psych diagnosis. The PCP should not be reporting the mental health diagnosis as primary after requesting a psychiatric consultation. You might need to contact the PCP's office to request they file a corrected claim with a different diagnosis.
    Last edited by lhallstrom; 08-09-2010 at 06:09 PM.
    Linda Hallstrom, CPC, CPMA, CPC-I, CEMC
    Richardson, TX AAPC Chapter

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