Wiki E/m at snf or nf

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rahammerl

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Local Chapter Officer
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Edelstein, IL
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I have an Infectious Disease provider who is seeing patients at a Rehab Center. The Rehab Center is credentialed as both Skilled Nursing and Nursing. Medicare has denied my claims because I entered an incorrect POS of 21 for an inpatient. My question is can I bill Medicare an E/M for Part B if the patient is in a skilled Part A stay? I am thinking I would need to bill the Skilled Nursing Facility for the E/M with a POS 31 if the patient is in a Part A stay and I can bill the E/M to Part B with a POS 32 if the patient is in a Non-skilled stay.

Does anyone have any experience with this situation?

Thanks!
 
EM at SNF or NF

You will want to contact the facility and ask their business office if the patient is in SNF stay or Long-term stay. That will determine which POS code to use. SNF is POS 31 and NF is POS 32. Regardless of the POS, you will use the appropriate EM code from 99304-99310. Additionally, regardless of the type of stay, physician's professional services are always billed to Part B Unless you live in some crazy jurisdiction that wants something different (hahaha). Good Luck!
 
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