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Nursing Home Coding

Nursing Home Coding

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Nursing Home Coding

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  1. Nursing Home Coding If using E&M coding, make sure your documentation justifies your 99307, 99308, or 99309 claim. Don’t let your documentation look “cookie-cutter”. If all your documentation looks alike, it raises question of authenticity. 3. The AOA says an OD can use the 92xxx exam codes when making nursing home visits, using the place of service codes of 31 (skilled nursing facility) or, more likely, 32 (nursing facility).

  2. Evaluation and Management Coding • There are three Key Components • History • Examination • Decision Making 99000 Evaluation and Management Codes

  3. Loss of Vision Evaluation of progression of

  4. Dx: Cataract – mngmnt options • Monitor; RTC 12 mo. • Advise regarding reading & lighting • Rx stronger reading addition due to cataract • Discuss possible Cat Surgery w/ patient • Recommend for Cat Surgery consult • Dx: AMD – mngmt options • Montior: RTC 6 mo • Rx & Instruct Re: Amsler grid • Rx AREDS treatment • Order Retinal photos to determine progression &/or need for consult • Order OCT to determine progression &/or need for consult Note: change in spectacle Rx is considered “none-covered” by this carrier, and thus is not a valid management option.

  5. PRESENTING PROBLEM: Minimal: Dry eye; old PVD; chronic blepharitis; vitreous floaters Low: Cataract; two minimal (above) Moderate: One chronic with mild progression: dry AMD; Two Chronic but stable: AMD and cataract High: RD; vascular occlusion; field loss; TIA; wet AMD

  6. Data Complexity will almost always be minimal for ODs as described in the E&M Guidelines. • If you feel you deserve any points for data complexity, it must be thoroughly documented in the patient record

  7. Final Code must beReasonable and Necessary • Considering • History • Presenting Problem • Clinical findings

  8. 92000 Comprehensive and Intermediate Coding • There are three Key Components • History • Examination • Decision Making

  9. Loss of Vision Evaluation of progression of

  10. Final Code must beReasonable and Necessary • Considering • History • Presenting Problem • Clinical findings