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Thread: billing requirements when pt is in physical rehab

  1. #1

    Post billing requirements when pt is in physical rehab

    AAPC: Back to School
    I have a pt who is in a rehab for a bilateral knee replacement, and comes to our office each month for Zoladex injections per prostate cancer. His office visit and injection has been denied per his being in a rehab. Does anyone know how this should be billed to Medicare to indicate this is seperate and not related to the rehab reason and not a Hospice situation?

  2. #2
    Join Date
    Apr 2007
    Sioux Falls South Dakota


    Is he in an inpatient rehab facility? If so, no OP/office services are payable. Or is he in a skilled nursing facility and you need to bill the SNF?

    If just OP Rehab, that shouldn't have anything to do with him coming to your office. So, I'm thinking it's probably either IP or SNF.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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