Urology Coding Alert

Question: Which CPT Codes and place-of-service codes should we report if the doctor sees a patient in the nursing home? Should we use the inpatient consultation codes (99251-99255 and 99261-99263) or comprehensive nursing facility assessment codes (99301-99303)? Is the place-of-service code 31?

New York Subscriber

Answer: Place-of-service codes for nursing facilities include 31 for a skilled nursing facility or portion of a nursing home, 32 for a nursing facility, and 33 for a custodial care facility such as an assisted living facility. For consultations performed in one of the above facilities, use CPT codes 99251 to 99255 (Initial inpatient consultation for a new or established patient...). 
 
Use the corresponding codes for the above facilities as described in CPT. Report a code from the 99301-99303 series for admission to a nursing home or for an NH inpatient comprehensive assessment. Use 99311-99313 for a resident requiring subsequent nursing facility care or for a nursing home resident who does not require a comprehensive visit or who does not have a new clinical problem. Use 99321 to 99323 for a custodial location (POS #33) new patient; report 99331-99333 for a custodial location established patient.