Author Topic: NURSING HOME CHARGES  (Read 1500 times)


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« on: December 07, 2008, 04:12:31 PM »
I enter charges for an Internal Med physician. I recently received a superbill for a visit to the nursing home but the patient was not there. They were on a LOA. The physician still wants to charge for the visit. Is she allowed to do this since she didn't actually see the patient. She went over the charts and made some changes in his medication while she was there. I have done searches and haven't found anything on it. Could someone point me in the right direction of where I might find my answer?


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« Reply #1 on: December 08, 2008, 10:22:59 AM »
My initial response would have been no, but I looked at the description of the cpt codes to see. 

They indicate that nursing home visits have to have 3 key components and then they give a typical amount of time for each code.  The amount of time states " 10 (or whatever) minutes with the patient and/or family and/or caregiver."  The and/or is the key word here.  If the dr spent time reviewing the patient's charts, made changes to medication, and consulted with the staff, then it would looks like it would be ok to bill for the appropriate level of NH visit based on the key components and time spent.

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