decisionhealth Newsletters, Part B News - 2005 Issue 10 (October)
2006 code changes: Confirmatory and follow-up inpatient codes to disappear from 2006 CPT codes
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Article Overview
This article reviews scheduled 2006 CPT evaluation and management changes that affect consult-related services and nursing facility reporting. It is intended for coders, billers, compliance staff, and physicians who need to understand which E/M service categories are being revised, how those changes relate to Medicare billing concepts, and what broad documentation and claim-handling issues may arise.
Why This Topic Matters
The article helps readers identify which E/M service categories are changing and why those changes matter for reimbursement, compliance, and day-to-day claim selection. It is especially relevant for practices that bill consults, inpatient follow-up services, or nursing facility visits.
Article Sections
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Overview of the 2006 E/M changes
Introduces the scope of the upcoming E/M revisions and the general billing impact on consult-related and nursing facility services.
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Confirmatory consult changes
Discusses the retirement of the confirmatory consult family and the broader transition away from that reporting category.
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Follow-up inpatient consult changes
Covers the elimination of the follow-up inpatient consult family and the related shift in how inpatient E/M services may be reported.
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Denial rates for confirmatory and inpatient follow-up consults 2004
Presents historical claims and denial-rate data for the affected consult categories.
What You Will Learn
- Which broad E/M service categories were slated for change in 2006
- How consult-related reporting was being discussed in relation to Medicare and other payers
- What types of nursing facility and inpatient E/M categories were part of the update
- Why historical claims data was included in the discussion
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians
- Practice managers
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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