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Issue Number - Name
0038 - Visits to Patients in Swing Beds
Review Type
Automated
Claim Type
Physician, Professional Services
Region and State
RAC 1-4
All States
Date Approved
2017-02-23

Description

If inpatient care is being billed by the hospital as inpatient hospital care, then hospital care codes apply. If inpatient care is being billed by the hospital as nursing facility care, then the nursing facility codes apply.

Affected Codes

  • 99221-99223, 99231-99233 and 99238-99239

Applicable Policy References

  • Social Security Act, Section 1833 (e)
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, 30.6.9