decisionhealth Newsletters, Coder Pink Sheets - 2006 Issue 10 (October)
‘New,' ‘established' not relevant to nursing facility codes
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Article Overview
This short Find-A-Code article addresses coding considerations for nursing facility admission and initial assessment services. It is aimed at coders, billers, and clinicians who need to understand how these E/M services differ from other visit types, especially regarding patient status and time-based code selection. The discussion focuses on general coding guidance and the scope of the applicable CPT nursing facility codes.
Why This Topic Matters
Nursing facility admission coding does not follow the same patient-status and time-based conventions used in many other E/M services. Understanding that distinction helps avoid misapplication of general E/M rules when selecting nursing facility initial assessment codes.
What You Will Learn
- How nursing facility initial assessment services differ from other E/M services
- Why patient status is treated differently for these nursing facility codes
- Why time is not used for selecting these nursing facility initial assessment levels
- What general factors are used to determine the service level
Who Should Read This
- Medical coders
- Billing staff
- Physicians
- Nurse practitioners
- Practice managers
Codes Discussed
Code Ranges Discussed
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