Wiki Billing long term care facility

[TLowe17]

Hello

I was wondering if anyone has experience in billing for providers that staff long term care facilities?

What CPT codes do you use for billing? Are Claims submitted once a month or daily?

Thank you,
Tracy L. CPC

 

[thomas7331]

Providers can't bill to staff a facility - staffing is an overhead cost of the facility and would be inclusive to the reimbursement that the facility is receiving. But medically necessary services rendered to individual patients for the management of their injuries or illnesses can be billed per CPT and ICD-10 coding guidelines. I'd recommend billing those daily as soon as possible after they occur to avoid aging and the possibility of timely filing issues.

 

[deepshikha]

Hello TL
I do billings for physicians who work part time with Nursing homes, & Longterm care facilities, and using codes 99305-99309. Being part time providers, billing is done every 2-weeks. In your case if the volume is large you can bill on weekly basis or as you deem optimum to your practice.

 

[lmamcelhaney@gmail.com]

Hello Deepshikha,

What POS do you use for your Long Term care facilities? Are you familiar with billing Residential Care Facilities? With the new guidelines we are billing 99305-99309 POS 33 and are receiving some denials for needing Prior Auth's from 1 Medicaid product in Missouri. But on other patients that are paying not needing PA. We can not figure out the rhyme or reason. Any help would be greatly appreciated!