Under Consolidated Billing, if a nursing home patient is in a skilled bed, then any lab services, IV antibiotics, etc., are billed to the nursing home and not to Medicare. Physician visits are still billed to Medicare Part B. The CMS article lists several examples of separately billable services - those can be billed to Medicare Part B. What's happening, basically, is nursing home patients who are put into "skilled bed" (or "swing bed") status become covered under Medicare as though they are hospital inpatients.
As far as what CPT codes and POS to use for physician visits to a nursing home (I assume you mean nursing home and not skilled nursing in a hospital), we're just starting to do that at my office so we're trying to figure it out, too! It sounds like you should bill POS 32 if the patient is in a skilled bed and use CPT codes 99304 - 99310. If they are NOT in a skilled bed, use POS 32 and CPT codes 99324 - 99337 - ? (again, assuming you mean in a nursing home - ) The POS doesn't sound right, but Medicare has told us specifically to use POS 32 for skilled patients in a hospital SNU (we learned this by being RAC audited).-- Maybe POS 31 should be used for a nursing home - ?
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