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Skilled nursing....

  1. Default Skilled nursing....
    Medical Coding Books
    I have patients records for skilled nursing facility (snf)that have telephone orders on successive days and coutersigned by the physician. Can these telephone orders be considered subsequent visit codes 99307-99310? Is it billable? What is the guidelines for billing telephone orders regarding reidents of snf?

    Thanks
    BOOGIE

  2. #2
    Location
    Richardson, Texas
    Posts
    170
    Default
    Nursing Facility Care codes (99304 - 99310, 99315 - 99316 and 99318) all require face-to-face time with the patient. Telephone orders are not separately billable. If the provider reviews and documents the results of those phone orders (Rx changes, lab, x-ray, etc.), that would be included in his/her interval history and/or medical decision making at the next face-to-face visit with the paitent.
    Linda Hallstrom, CPC, CPMA, CPC-I, CEMC
    Richardson, TX AAPC Chapter

  3. Default Skilled nursing
    Thank you so much for your reply.
    So if the md have successive telephone orders for 5 days, those will be disregarded? We only code for the ones that there is an actual soap, right?
    Have a good day
    BOOGIE

  4. #4
    Location
    Richardson, Texas
    Posts
    170
    Default Face-to-Face Required
    The healthcare provider must actually see and examine the patient and document that visit in order to report the service. Generally, if orders are needed several sequential days, the patient needs to be examined. Most E/M codes require face-to-face time with the patient -- and Medicare only reimburses for face-to-face E/M services.
    Linda Hallstrom, CPC, CPMA, CPC-I, CEMC
    Richardson, TX AAPC Chapter

  5. Default
    You're awesome... Thanks.

    What about if the patient, while on her stay she had a cardiac arrest did cpr and sent to the hospital and the patient was sent back to the facility, should i code for subsequent visit or re-admission?

    Secondly, if the nurse practitioner is the one that is doing the progres notes for the patient but the md was not "per" upon signing, is that a codable condition?

    Thanks.
    BOOGIE

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