decisionhealth Newsletters, Part B News - 2013 Issue 11 (November)
Benchmark: Initial and subsequent nursing facility E/M code use on the rise since 2010
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Article Overview
This article reviews utilization and denial trends for nursing facility evaluation and management services in skilled nursing facilities and nursing facilities, based on Medicare billing data from 2010 to 2012. It is relevant to coders, billing staff, compliance teams, and clinicians working with facility E/M reporting, and it discusses broad differences in how initial and subsequent visits are billed, who typically furnishes them, and how denial patterns changed over time.
Why This Topic Matters
Understanding billing and denial trends for nursing facility E/M services can help organizations monitor coding patterns, payer scrutiny, and provider participation in these settings.
What You Will Learn
- How nursing facility E/M billing trends changed over the study period
- How initial and subsequent visit patterns differ in skilled nursing and nursing facility settings
- Which provider types commonly bill these services
- How denial trends compare between initial and established visit categories
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians
- Non-physician practitioners
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
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