- June 19, 2023
- Posted by: Steve Smith
- Category: Skilled Nursing Facility Billing
Regardless of the type of medical specialty, healthcare professionals like physicians or nurses are always busy providing healthcare aid in a Skilled Nursing Facility. Patients come here for the extra or continued care they might require after they’ve been discharged from hospitals. Typically speaking, an SNF serves in different capacities and is staffed with professionals providing different services on time and in a cost-effective manner. Let us have a look at some of the services provided by an SNF.
Types of Services Provided by Skilled Nursing Facilities
At times, Skilled Nursing Facilities are referred to as Nursing Homes. SNF billing is frequently confused with Nursing Home billing. However, they are all different in various little but significant ways.
Broadly speaking, SNFs intend to provide different kinds of healthcare aid such as:
Long Term Care (LTC) – Patients who are in need variety of services – both non-medical and medical – specifically suffering from disability or chronic illness, or are unable to support themselves on their own for longer periods. LTC can be provided to patients who require on-site supervised care such as medical services as well as housekeeping services.
Skilled Nursing Aid – Patients who require medical assistance requiring, dressing changes, IV therapy, injections, medical administration, and others.
Rehabilitation Care – Patients who require immediate occupational therapy to fully or partially recover from a serious injury, or surgery.
Healthcare practitioners such as certified nursing assistants (CNAs), licensed practical nurses (LPNs), and many other non-physician professionals are certified to provide different kinds of support in a Skilled Nursing Facility. However, the initial doctor’s visit is done by the admitting doctor, as governed by long-term care protocols.
Appropriate Skilled Nursing Facility Codes
Let us take a quick look at various facets of medical coding required for skilled nursing facility.
To properly document a Skilled Nursing Facility medical record for a patient, physicians need to code appropriately. Skilled Nursing Facilities need to abide by the following CPT codes for creating accurate and acceptable medical reports, as governed by federal regulations. These, however, are just of the many codes that they are typically required to handle.
A Skilled Nursing Facility, on an average daily basis, needs to use CPT codes such as 99310, 99308, 99307, and 99309, to report federal compliant medically required E/M and physician E/M visits.
However, as per federal rules and protocols, insurance providers are prohibited to pay not more than one Evaluation and Management (E/M) visit performed by any healthcare professional or a non-physician practitioner (NPP) for the same patient or on the same date of service.
A Final Word
What happens when insurance providers are unable to interpret the medical documentation properly? In such situations, a healthcare professional (HCP) runs the risk of experiencing delays in receiving payments or even faces the possibility of claim denial. Medical coding is one of the important aspects of medical billing, and is extremely significant in the context of documentation and getting reimbursed within the healthcare domain. These codes act as a universal language for both healthcare professionals as well as insurance providers to understand the patient’s medical information and condition.
To avoid the crisis that results from erroneous coding, Skilled Nursing Facility healthcare professionals are strongly encouraged to get in touch with expert revenue cycle management service providers with professionally trained medical coders and billers on board, to handle all billing and coding tasks and collect payment from the insurance providers on time.