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We have a provider who is looking to spend one day a month at another clinic’s facility and we will be renting the office space. We have no affiliations with this clinic and our office will being doing the billing.
Should we code the place of service as 11(Office) or 49(Independent Clinic)?
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MY question is
our practice bills medicare medicaid and alot of commercial insurances. When we bill to medicare and medicaid how do we know whether to use place of service 50 (fqhc) or 11 (office).
Example ::: pt comes in with medicare and bcbs. does medicare go to place of service 50 and bcbs go to place of servie 11?
Example ::: medicare and medicaid. do we bill both with place of service 50 or medicare to 50 and medicaid to 11??
Does all commercial just go out with place of service 11???
Quite confused. Any and all help will be greatly appreciated.
Tina
Does anyone happen to have the a link to the AMA Pre, Intra, Post Service times for procedures and EM services?
I know that this is put out by the AMA RUC Committee and is used by CMS for RBRVS, but cannot find the actual document that contains these times.
I have tried to email the AMA but have had no luck.
If anyone happens to have this information it would be very much appreciated!
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
If one of our PA’s or NP’s sees patients in a nursing home outside of the office setting for medication management (E/M) what CPT codes would be used and would there be modifiers needed?
In the office setting we would normally use the E/M codes, so would these still be used (99211-99215) with modifiers in the nursing home(assisted living facility)? Or should the nursing facility services codes be used? Which CPT codes should we be using?
Thank you