Wiki New coder needs help

[lovewdisney1]

Can anyone help me with what E&M codes to use for the Veterines Facility. The doctor I work for goes to the Vets facility 2-3 times a year. I am working on rejections from the previous biller.

Should I use the 99304 -99306 for the initial visit and 99307 - 99310 for established visits even though they might be 4-6 months apart.

Or should I use 99324-99328 for initial and 99334-99337 for established

Thanks for any advice

 

[tmoore0214]

What did your doc do there you have to give more information than that please!

 

[smweiss]

what type of doctor are you working for? did he do a consultation for another doctor? or did he just do a routine or sick visit?

 

[garmab06]

it seems that these are Nursing home living assited visits need to get more information, is this the Veterans Administration facility?


Garcia06
Tucson Az

 

[mmorningstarcpc]

There are different levels of "nursing home care." You have "nursing facilities," intermediate care facilities" and "long-term care facilities." See instructions in the CPT book. These have CPT codes, as well as POS codes appropriate to the level of care given. Also, Assisted living facilities are not "nursing" care facilities. If a physician sees a patient in an assisted living apt, this is consider a "home" visit, as this is the patient's home, not a "nursing home" visit.

Your E/M level would then depend on what type of "nursing care" was given, as well as if it was regular admission to nursing home or subsequent visit, as well as if the physicain was asked by the regular attending physician to consult on a specific issue.

If you read the CPT guidelines closely, you should get your answer.