AAPC - Back to school
Results 1 to 3 of 3

Thread: Nursing home readmit

  1. #1

    Default Nursing home readmit

    AAPC: Back to School
    Not sure if anyone has any insight on this. CMS is kind of hard to understand. One of my doctors has been seeing a patient in a nursing home for CHF and COPD. She was recently hospitalized for 3 days due to anemia with chronic blood loss requiring blood transfusions. When she was discharged from the hospital, she was sent back to the nursing home. My physician wants to know if he can bill an initial nursing home visit (99306) or does he have to go to using the subsequent nursing home visit (99310) after she was discharged and sent back to the NH? He had to write up a new plan of care for her including the anemia due to chronic blood loss, not sure if that matters though. It sounds like CMS is saying "30 days" but it isn't real clear on nursing home -> hospital -> nursing home billing. It seems like it was more for hospital -> nursing home -> hospital readmission.

    Is there anyone that can clarify this for me?

    Many thanks for any assistance!

  2. #2
    Join Date
    Apr 2007
    SE Minnesota

    Default Any response?

    I know this post is from a while back, but it is the exact question that I had. Did you ever get any response? What did you figure out?

    I have a provider who was told they could charge an Initial NH code again, even if they had been the primary provider during the previous NH stay. Personally I don't think that is right since the patient is essentially established.

    Your thoughts would be appreciated.
    Cory Bauer
    Rochester, MN

  3. #3
    Join Date
    Apr 2007
    Seacoast- Dover New Hampshire


    I too am having the same issue. Pt has been in Nursing home for along time. Became ill with heart issues, got admitted IP. was stabilized and d/c. by Hospitalist. MD of nursing home wants to do readmit 99306?
    Karen Barron, CPC
    Hampton New Hampshire Chapter

Similar Threads

  1. Nursing Home E/M
    By johnshawna1 in forum E/M
    Replies: 2
    Last Post: 05-06-2015, 11:38 AM
  2. Nursing Home
    By akmorgan in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-28-2012, 01:38 PM
  3. Nursing Home
    By Partha in forum E/M
    Replies: 0
    Last Post: 01-08-2010, 10:06 AM
  4. Nursing home
    By lzellers in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 03-23-2009, 02:29 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.