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Issue Number - Name
0061 - Excessive Units of Nursing Facility Services
Review Type
Automated
Claim Type
Professional (Physician/Non-Physician Practitioner)
Region and State
RAC 1-4
All States
Date Approved
2017-09-06

Description

The Nursing Facility Service codes represent a “per day” service. As such, these codes may only be reported once per day, per beneficiary, provider and date of service.

Affected Code(s)

  • CPT Codes 99304, 99305, 99306, 99307, 99308, 99309, 99310

Applicable Policy References

  • Title XVIII of the Social Security Act, Section 1833(e)
  • Title XVIII of the Social Security Act, Section 1862(a) (1) (A)
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6.13(B)
  • American Medical Association, Current Procedure Terminology 2014 to current