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Nursing Home - Need Inputs

  1. #1
    Default Nursing Home - Need Inputs
    Medical Coding Books
    Mental health provider seeing patient in nursing home billing nursing home visits 99307-99309 and getting denied from Behavioral Health plans. Any suggestions how these services should be billed? Is it ok to bill outpatient/office established?

    Suggestions will be greatly appreciated!

  2. #2
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    That's interesting. Please share what their denial reason is. Thanks!
    Donna E. Young, CPC

  3. #3
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    Quote Originally Posted by Partha View Post
    Mental health provider seeing patient in nursing home billing nursing home visits 99307-99309 and getting denied from Behavioral Health plans. Any suggestions how these services should be billed? Is it ok to bill outpatient/office established?

    Suggestions will be greatly appreciated!
    What is the mental health provider seeing patient for? Purpose of visit? I am thinking billing a mental health code with POS as NH might be better

  4. #4
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    Mental health provider is seeing the patients in NH for some mental health problems first as consult and then followup.

    When used 99307 reason for denial Dr not allowed to perform in this POS. So, we are thinking of using 99241-99245 for initial consult outpatient and then 99212-99215 for follow up visits.

  5. #5
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    What is the intent of the visit?

  6. #6
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    Followup mental health problems

  7. #7
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    If hes not doing therapy, then I would say a regular EM

  8. #8
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    So 99212-99215 and POS outpatient??

  9. #9
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    99211-99215 and POS should be nursing home

  10. #10
    Default confused
    We have some instances that are getting denied as well. We are billing a nursing home visit such as 99307 for a primary care visit and then 99307 for the mental health visit. Primary care visit may be for something like cough or bronchitis and the mental one for dx of DYSARTHRIA. Would using the 99307 be correct or should we use for example 90816 90817?? or a 99211-99215 with POS as nursing home?? I am confused. Oh also keep in mind in this example two different providers. One an MD and the other PMHNP
    Last edited by ebredehoeft; 08-05-2010 at 12:03 PM.

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