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General Surgery Coding Alert

READER QUESTION:

POS Gives Clue to NF Service's Codeability

Published on Thu Jan 04, 2007

Question: Our surgeon discharges a patient from the hospital and then admits him to a nursing facility (NF). The physician did not go to the NF for this admit or perform a follow-up. Should I charge an NF visit?


Washington Subscriber


Answer: No. You should code only the hospital discharge (99238, Hospital discharge day management; 30 minutes or less; or 99239, - more than 30 minutes).

The nursing facility admission (99304-99306, Initial nursing facility care, per day, for the evaluation and management of a patient -) requires a face-to-face physician-patient encounter at the facility.

Tip: Checking the place of service (POS) will help you recognize whether an NF service deserves coding. POS codes must match billed service codes. You have to use 99304-99306 with POS 31 (Skilled nursing facility) or 32 (Nursing facility), and 99238-99239 with 21 (Inpatient hospital). If the surgeon was never in POS 31 or 32, you cannot charge for any 99304-99306 services.
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