Forum - Questions & Answers

May 30th, 2009 - Sammi 15 

Nursing home / Discharge

When billing Masshealth what code can I use for a nursing home discharge. They do not accept 99315-99316. Is there in fact a code I can use or do I just bill it as a regular visit?

May 30th, 2009 - nmaguire   2,606 

masshealth

Appeal the denial:
Refer to the official list of HCPCS codes and descriptions as posted on the
Centers for Medicare and Medicaid Services Web site at www.cms.gov/medicare/hcpcs when billing for
services provided to MassHealth members.

MassHealth pays for services billed using all medicine, radiology, laboratory, surgery, and anesthesia CPT codes in effect at the time of service, except for those codes listed in Section 602 of their manual, subject to all conditions and limitations described in MassHealth regulations at 130 CMR 410.000 and
450.000, and in the most current Acute Hospital Request for Application.

Sep 30th, 2009 - Sammi 15 

Masshealth Discharge

I was told by Masshealth to bill an E&M code. They will not bill discharge codes.



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