You would use condition code 54 when there are no skilled nurse visits in the PDGM period - according to my notes.


Crisa Mortenson

Billing Officer

 Phone: 218-843-3852

Fax : 218-843-2311

Email: crisa.mortenson@kmhc.net

 1010 S Birch Ave. P.O. Box 700

Hallock, MN 56728


From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Marnie Pogreba <marniepogreba@lakewoodhealthsystem.com>
Sent: Monday, March 4, 2024 2:25 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Therapy Billed thru Med B
 

I am not sure I am going to answer your question or not.  No matter what part of Medicare covers the home health care, A or B, the patient still needs to meet the homebound and skilled need requirements.  If they meet those requirements, then they qualify for home care and you can bill the BCBS Advantage plan.  If they do not meet those requirements, they would need to go to outpatient for therapy.

 

 

 

 

    

Marnie Pogreba

Home Care and Hospice

OFFICE: 218 894 8324

Fax: 218 894 8099

 

LAKEWOOD HEALTH SYSTEM, SENIOR CAMPUS

401 Prairie Ave NE| Staples, MN 56479

 

 

 

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Cyndi Onkka
Sent: Monday, March 04, 2024 1:57 PM
To: billers@list.mnhomecare.org
Subject: Therapy Billed thru Med B

 

**External Sender**

 

I don’t know much of anything about billing visits for Med B services.  Does anyone have recommendations on how to bill a PT eval assessment for Med B?  We had a referral that ended up not needing nursing but could benefit from some therapy through Med B.  This person is on an Advantage Plan thru BCBS.

 

Cyndi Onkka, Assistant Director

Pennington & Red Lake County Public Health & Home Care

 

101 Main Ave N

Thief River Falls, MN 56701

Phone: 218-681-0876

Fax: 218-683-7099

 

 

https://pennredlakecopublichealth.com

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