Forum - Questions & Answers

Jan 11th, 2010 - vbchappell

Coding separate E & m visits on same day

I need a modifier. The discharging physician charges an E&M visit on the final discharge day. The patient is returned to a nursing home. Upon entering the nursing home, the nursing home provider performs another E&M evaluation.
What is the modifier used to denote the second visit as a separate and distinct procedure?

Jan 11th, 2010 -

no modifier needed

from WPS: We received confirmation from CMS on this question. When the physician is performing the assessment for the admission to the SNF or NF at the hospital, the physician may bill this using POS 31 - SNF or 32 - NF. If the patient is discharged from the hospital and admitted to the SNF or NF on the same day, both services may be approved by Medicare when the physician provides both services. There are requirements as to the time-frame for the assessment and plan of care for the patient in a SNF. You can find more information in the CMS IOM Publication 100-04, Chapter 12, Section 30.6.13.



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