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Thread: Specialists & Initial Nursing Home Visit

  1. #1

    Default Specialists & Initial Nursing Home Visit

    AAPC: Back to School
    Gastroenterologist goes to nursing home for initial visit. He is not the admitting doctor. Are codes 99304-99306 appropriate? We have been using 99307-99310 for initial visits because we are not the admitting doctor. Please advise. Thank you

  2. #2


    Yes they the correct codes i bill for an Infectious Disease MD and I have been using 99306 hope this helps

  3. #3
    Join Date
    Apr 2007
    Nashville, TN

    Default Level billed for specialist Visit in Nursing Home

    Wouldn't the level used depend on the elements as outlined in the E&M Guidelines? Use of the 99306 for all specialist visits? Please clarify.

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    Per the Dec 14 transmittal:
    B. Policy: Effective January 1, 2010, the consultation codes are no longer recognized for Medicare Part B payment. Physicians shall code patient evaluation and management visit with E/M codes that represent where the visit occurs and that identify the complexity of the visit performed. In the inpatient hospital setting and the nursing facility setting all physicians (and qualified nonphysicians where permitted) who perform an initial evaluation and management may bill the initial hospital care codes (99221 – 99223) or nursing facility care codes (99304-99306). As a result of this change, multiple billings of initial hospital and nursing home visit codes could occur even in a single day.
    I agree that you cannot say they are all 99306 encounters with out benefit of the documentation it must meet the componets of that level to be billed as that level.

    Debra A. Mitchell, MSPH, CPC-H

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