AMA CPT® Assistant - 1998 Issue 5 (May)
Using the Nursing Facility Codes (May 1998)
May 1998 pages 1-4 Using the Nursing Facility Codes The first step in understanding the nursing facility codes is to look at the Nursing Facility Service guidelines, which have been revised in CPT 1998, and can be found on page 31. The codes presented in this article are used to report evaluation and management services to patients in: Nursing Facilities (formerly called Skilled Nursing Facilities (SNFs); Intermediate Care Facilities (ICFs); or Long Term Care Facilities (LTCFs). These codes should also be used to report evaluation and management services provided to a patient in a psychiatric residential treatment center (a...
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Article Overview
This article explains how CPT nursing facility evaluation and management services were organized and reported in 1998. It is relevant to physicians, coders, and billing staff working with nursing facility, intermediate care, long-term care, and related residential settings. The discussion covers the structure of the service categories, documentation and assessment concepts, admission and readmission considerations, discharge services, and the broader reporting context for facility-based E/M care.
Why This Topic Matters
Nursing facility E/M coding involves distinct service categories and reporting situations that differ from office or hospital coding. This article helps readers understand the scope of the CPT guidance and the kinds of circumstances addressed in the premium content.
Article Sections
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May 1998 pages 1-4
Introduces the article topic and frames the CPT nursing facility coding guidance covered in the issue.
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Using the Nursing Facility Codes
Provides the main overview of nursing facility E/M services, including applicable care settings, assessment concepts, and the structure of the reporting guidance.
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Types of Nursing Facility Services
Describes the major nursing facility service categories and the general factors used to distinguish them.
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Nursing Facility Assessments
Discusses assessment-related guidance, admission and readmission context, and related reporting considerations.
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Hospital Discharge Service Codes
Covers discharge-related reporting circumstances when nursing facility admission or readmission occurs on the same date as hospital or observation discharge.
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Reporting Circumstances that are Specific to Nursing Facility Services
Explains circumstances unique to nursing facility service reporting and provides the article’s code-by-code discussion framework.
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Subsequent Nursing Facility Care
Reviews the lower-intensity nursing facility E/M service category and the general situations it addresses.
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Nursing Facility Discharge Services
Describes discharge-day management services for nursing facility patients and the general time-based reporting framework.
What You Will Learn
- How CPT nursing facility E/M services are organized
- Which care settings are addressed by the article
- How assessment and subsequent care categories are distinguished at a high level
- What kinds of discharge-related reporting situations are discussed
- How the article frames nursing facility service documentation and timing concepts
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Compliance staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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