AMA CPT® Assistant - 2023 Issue 1 (January)
Questions and Answers (January 2023)
January 2023 page 28 Questions and Answers Evaluation and Management (E/M): Nursing Facility Services Question: If a patient transitions from a nursing facility to a hospital as an inpatient and then back to a nursing facility, would it be considered as an initial level of care when the patient returns to the nursing facility? Answer: If the patient were discharged from the nursing facility and returns for a new nursing facility stay post-hospital discharge, the assessment, if performed by a physician or other qualified health care professional on the return, would be considered an initial level of care. This...
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Article Overview
This January 2023 CPT Assistant Q&A article addresses a range of coding scenarios spanning evaluation and management, hospital inpatient care, critical care, integumentary procedures, cardiology, surgery, radiology, and psychotherapy. It is useful for coders, auditors, and billing professionals who need to understand how CPT 2023 guidance applies to service timing, reporting structure, modifiers, add-on services, and code changes across specialties.
Why This Topic Matters
The article helps readers identify which parts of CPT 2023 guidance are relevant to real-world reporting situations and where coding rules changed or were clarified. It is especially relevant for professionals who work across multiple specialties and need current guidance on modifiers, add-on codes, and cross-year reporting.
Article Sections
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Evaluation and Management (E/M): Nursing Facility Services
Addresses a transition scenario involving nursing facility care after hospital discharge and the related 2023 CPT reporting context.
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Hospital Inpatient and Observation Care Services
Discusses how services are reported when a hospitalization spans two calendar years and how CPT versioning affects reporting.
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Inpatient Neonatal and Pediatric Critical Care
Covers pediatric critical care reporting questions involving age-based descriptors and CPT 2023 guidance.
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Integumentary: Destruction Benign or Premalignant Lesions
Reviews coding guidance for destruction procedures involving vascular and benign lesions, along with broader CPT descriptor interpretation.
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Cardiology: Arterial Mechanical Thrombectomy
Explains reporting considerations for pulmonary arterial thromboembolectomy procedures within the arterial mechanical thrombectomy subsection.
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Surgery: Female Genital System
Addresses reporting for a discontinued intrauterine device insertion and the related modifier context.
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Surgery: Nervous System
Discusses reporting for noninvasive navigated transcranial magnetic stimulation brain mapping and related deleted and unlisted code references.
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Auditory System: Introduction
Covers cochlear implant removal and replacement, including reporting considerations and postoperative documentation context.
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Radiology: Ultrasonic Guidance Procedures
Addresses ultrasound guidance reporting in the setting of TIPS procedures and how add-on guidance coding is handled in CPT 2023.
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Medicine: Psychotherapy
Explains psychotherapy reporting changes tied to deleted prolonged services codes in CPT 2023.
What You Will Learn
- How the article frames several CPT 2023 Q&A topics across different specialties.
- Which types of service scenarios are discussed in relation to current coding guidance.
- What broad categories of coding changes, modifiers, add-on services, and reporting updates are covered.
- How the article treats cross-year service reporting and deleted code references.
- Where the article directs readers to consult specialty-specific CPT guidance and payer policies.
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Revenue cycle professionals
- Compliance teams
- Physician practice administrators
- Specialty clinic coding staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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