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Code for Second Opinion in NH

  1. #1
    Location
    Grand Rapids, MI
    Posts
    17
    Question Code for Second Opinion in NH
    Medical Coding Books
    I have a Dr. who does occassional second opinions on nursing home patients when there is a concern about the patients ability to make responsible medical decisions for themselves. There is a very limited ROS and Exam, mostly all psych eval. Since my doc is doing the second opinion, he is also reviewing the initial physicians records.

    What code should I use? An initial nursing visit doesn't sound appropriate - but maybe?

    HELP!

    Thx,
    KLB, CPC

  2. #2
    Location
    Grand Rapids, MI
    Posts
    17
    Default
    Anyone?

  3. #3
    Location
    Grand Rapids, MI
    Posts
    17
    Default
    Please HELP!

    Thx
    KLB, CPC
    "Sucess is not final, failure is not fatal; it is the courage to continue that counts." Winston Churchill

  4. #4
    Default Nursing home consults
    Same rules as inpateint care:
    The admitting physician of record will bill hospital or skilled nursing facility (SNF) admission work using the initial hospital care CPT codes 99221-99223 or initial SNF care codes 99304-99306, with a new modifier, AI, appended to the visit CPT code.

    For an SNF consult, the consultant will bill an initial SNF care code (without the admitting physician modifier).

    For subsequent inpatient hospital or SNF care, both the admitting and non-admitting physician(s) should bill Medicare hospital or nursing facility admissions using the initial hospital care CPT codes or initial nursing facility care codes 99304-99306, without the modifier.

    http://www.acpinternist.org/archives...1/practice.htm

  5. #5
    Location
    Grand Rapids, MI
    Posts
    17
    Default
    Thanks!
    KLB, CPC
    "Sucess is not final, failure is not fatal; it is the courage to continue that counts." Winston Churchill

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