Nursing home E/M codes to change next year

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains upcoming changes to nursing home evaluation and management coding for the following year. It is aimed at coders, compliance staff, and practice managers who need to update superbills and review how the revised code structure affects nursing home visits, admissions, re-admissions, and subsequent care. The discussion stays at a high level and focuses on the general nature of the changes and the operational impact on billing workflows.

Why This Topic Matters

Nursing home E/M code changes can require immediate updates to superbills, billing systems, and documentation practices. Understanding the scope of the revisions helps practices prepare for coding transitions and review whether their current processes still align with the revised nursing facility visit structure.

What You Will Learn

  • Which nursing home E/M services are affected by upcoming code changes
  • How code deletions and replacement code series may impact superbills
  • What general categories of nursing facility visits are being revised
  • Why practices may need to review documentation and billing workflows
  • Which parts of the nursing home code structure are expected to be updated next year

Who Should Read This

  • Medical coders
  • Compliance officers
  • Healthcare managers
  • Practice administrators
  • Billing staff

Codes Discussed

Code Ranges Discussed

  • CPT: 99307–99310
  • CPT: 99311–99313
  • CPT: 99304–99306

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