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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

Place of service for Nursing and assisted living facility

Current Procedural Terminology (CPT) Codes 99304 Through 99318

The CPT nursing facility services codes shall be used with POS 31 (skilled nursing facility or SNF) if the patient is in a Part A SNF stay. They shall be used with POS 32 (nursing facility) if the patient does not have Part A SNF benefits or if the patient is
in a NF or in a non-*‐covered SNF stay (e.g., there was no preceding three-*‐day hospital stay). The CPT NF code definition also includes POS 54 (intermediate care facility/mentally retarded) and POS 56 (psychiatric residential treatment center).

CPT Codes 99324 Through 99328 and 99334 Through 99337 :

Domiciliary, rest home (e.g., boarding home) or custodial care services are used to report Evaluation and Management (E/M) services to residents residing in a facility which provides room, board and other personal assistance services, generally on a long-*‐term basis. These CPT codes are used to report E/M services in facilities assigned POS codes 13 (assisted living facility), 14 (group home), 33 (custodial care facility), and 55 (residential substance abuse facility). Assisted living facilities may also be known as adult living facilities.

Narashiman.R COC CPC

Medical Billing and Coding Forum

Facility observation coding in ED- commercial payer

Hi all!

My boss says that code 99218 has to be added multiple times to get reimbursement (added once for every 30 min that the patient is observed) So let’s say the patient was observed for 6 hours, according to her it must be added 12x. Makes no sense to me. Shouldn’t the 99218 be coded just once in this case?

This is for facility coding. I have tried to show her the CPT description that says ‘per day’ but she says that’s for physician billing. Do you guys know of any guideline that I could show her in regards to this? PLEASE advise!! Thanks.

Medical Billing and Coding Forum

Obtaining Correct POS From Facility SNF/Assisted

My Dr does rounds at a local what I thought was a SNF, I billed 99305 with POS 31 the address of the facility and the referring physician but still recieved denials from Medicare. Do I continue to try and get ahold of someone to ask at the facility or do I call and ask Medicare?

Medical Billing and Coding Forum

Billing facility room charge with 99212

I work in a critical access hospital in a remote area. We have specialists that come out to our facility and see patients through our specialty clinic. Our Ortho doctors will see patients in our area and then will do surgery back at the hospital in the city that they work in. They will then have follow up/post op visits again at our facility. Does anyone know for sure if we can bill for the room charge only? We do not handle the pro fees for the doctors and we know the post ops are included with the procedure. We typically bill a 99212 on a UB for the room only for a typical visit but are not sure if we can even do that on a post op visit.

Medical Billing and Coding Forum

UB04 box 76 OP facility claim

We are an outpatient facility billing for IOP on UB04 claims. The counselors there do not have NPI’s so we’ve always billed with our medical directors name and billing NPI. Is this accurate? Should we bill with the LADC provider name and facility NPI or is either correct? I was taught to bill the way we have been with the directors name and claims do get processed/paid, just always questioned if this was the best or most accurate way to bill. Thanks in advance for any advice.

Medical Billing and Coding Forum

Get to Know the Nuances of Skilled Nursing Facility Consolidated Billing

Adhere to the Medicare requirements and bundling rules for SNF coverage payment. If you don’t work in a skilled nursing facility (SNF), you may not understand how SNF consolidated billing (CB) affects you. The way you answer the following two questions may help you to see the connection: Have you ever had a Medicare patient […]

The post Get to Know the Nuances of Skilled Nursing Facility Consolidated Billing appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Private practice ultrasound billing & facility fees

We are a private ob/gyn practice and own our ultrasound equipment. We perform, read & bill our ultrasounds. Another physician told one of our physicians they also bill a facility fee. This practice is also a private practice. Has anyone ever heard or billed this?

Medical Billing and Coding Forum

Facility billing- Can newborns be billed as inpatient OR outpatient ?

We currently are following the 2 midnight rule in regards to billing the mother’s delivery as either outpatient or inpatient.
Initially we billed all deliveries as Inpatient but some moms leave the next day so we have now applied the 2 midnight rule to determine whether the mom is inpatient or outpatient. My question now is what about the newborn billing?? I feel like the newborn billing should match the mother’s billing, if moms billing is outpatient so should the newborns be. But up to now we have been billing the newborns as inpatient.

Wondering what input anyone has on this facility billing regarding outpatient or inpatient for Deliveries and Newborn admits/discharges.

TIA
KAM

Medical Billing and Coding Forum