initial nursing facility visit

edited May 2017 in Primary Care
I think it is clear that when a resident of a nursing facility is admitted to the hospital and then returns to the nursing facility, then at the time of the first visit at the nursing facility (we have a physician that sees patients at the nursing facility), the physician can submit the service using the "initial nursing facility" codes. I am hoping everyone agrees with me on that. So, despite the fact that the patient may have been a resident of the nursing facility for 5 years, when the patient is returning to the nursing facility after an intervening hospital stay, the physician visit is submitted as an "Initial nursing facility" code.

Assuming that everyone agrees this code selection is appropriate, what if the nursing facility resident just went to the emergency room (say for a laceration that needed sutures) and then, immediately returned to the nursing facility (i.e., the patient was not admitted)? Would the next visit by the physician in the facility use the "initial nursing facility" codes or the "subsequent nursing facility" codes? Thank you. Richard Fairley, MD, Dubuque Internal Medicine, Dubuque IA 
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