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Saturday, May 27, 2017
News & Perspective Drugs & Diseases CME & Education Academy
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Medicare Reimbursement for Nurse
Practitioners in Long-term Care
Authors: Stephanie A Lusis, MSN, APRN, BC; Faculty and Disclosures
Medicare Reimbursement
Covered Services
Incident-to Billing
History
Physical examination
Medical decision-making
Counseling
Coordination of care
Nature of presenting problem
Time
Number of diagnoses or
management options
Amount and/or complexity of data to
be reviewed
Risk of complications and/or
morbidity or mortality
Domiciliary Services
Documentation Requirements in
Nursing Facilities
Place of Service
Diagnoses
Key References
The Physician's Current Procedural
Terminology (CPT book) provides
definitions and procedures for the use of
E/M codes. It includes 1995/1997
Documentation Guidelines for Evaluation
and Management Services, the Table of
Risk, and time frames for various service
levels. An updated version is available
yearly and must be purchased by the
billing service.
International Classification of
Diseases,9th edition (ICD-9) provides
codes for medical diagnoses (reasons for
visits).
References
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