Wiki Doing a cardiology consultation at a nursing home

[cardiocoder]

A patient is currently at a nursing home and taken care of by an Internal Medicine doctor. She is on dialysis and needs a preop assessment for fistula. The internist calls a cardiologist to evaluate her in the nursing home to do preop risk assessment and get a stress test.

Does the cardiologist code 99306 (initial nursing home visit) or 99204 (New Office visit)? The internal medicine doctor is currently listed as her attending at nursing home and I assume had already billed medicare 93306 a few months ago when she was first admitted to nursing home.

 

[teresabug]

if the cardiologist is seeing the pt in the nursing home, you bill the appropriate 9930X code with POS 31 if it is a skilled nursing facility (SNF), of course based on his documentation. I this patient comes to the cardiologists office via ambulance or personal/family transportation and the cardio has never seen this pt before, he would bill a new pt E/M code and also the stress test code, Depending on if the equipment is owned by him. If the Dr does not own the equipment, then you would append a 26 modifier on the stress test.