Medical Coding Questions: CPT Nursing Facility Services. This one is Alicia’s.

Diane asked, “Nursing home resident monthly visit note. If you’re seeing a resident for their required visit… and the keyword there is ‘required’… the MD says, “No complaints, nothing acute.” How can you code this? I think you have all sorts of diagnoses, all sorts of medication and just say, “Will continue current meds. Will follow routinely.” The company expects me to bill them but where’s the medical necessity except for the fact that is a required visit by Medicaid/Medicare.

Medical Coding Question: How To Code For Nursing Home Visits 

Well, when you’re doing a skilled facility, it’s required for the doctor to come in and evaluate routinely the patient. So he gets paid for that and the code range for that is in nursing facility services. It’s an E&M code. They’re 99304 through 99318. And the key is ‘provides continuous healthcare service to patients who are not actually ill’. But they do get paid for coming in and visiting and examining that patient. So you have some choices that I picked out. “Stable, recovering or improving” which, for this example, would be the perfect code, 99307 because the patient’s stable. They’re not making any changes. They’re recovering or they’re improving. And then you have other choices: not responding or minor complications, significant complications or new problems, significant new problem: require immediate physician attention.

So there are codes for that and they are expected. That’s why they’re wanting you to bill for that. Another medical coding question answered!

Related Medical Coding Question Posts:

Submit your review

Create your own review

Average rating:  
 0 reviews