Part B Coding Coach: How To Earn More For Complicated Nursing And Rest Home Visits In 2006

Why This Topic Matters

These 2006 updates changed how several long-term care and domiciliary E/M services were organized and reported, making them important for accurate claim submission, reduced denials, and correct selection of service level in affected settings.

Article Sections

1. Change #1: Nursing Facility Services adds new subsection and new codes.

   Introduces the updated nursing facility structure and the general categories of service affected by the 2006 revisions. The section explains the broader shift in how these visits are organized for reporting.

2. Change #2: Subsequent Nursing Facility Care subsection gets new codes and level of service.

   Covers the revised subsections for ongoing nursing facility care and the expanded service framework. It also notes the broader documentation elements discussed for these services.

3. Change #3: New annual assessment code 99318 finds home in Other Nursing Facility Services subsection.

   Discusses the annual nursing facility assessment category and where it fits within the updated CPT structure. The section also addresses how this service is distinguished from other nursing facility care reporting.

4. Change #4: Domiciliary, Rest Home, or Custodial Care Services section gets all new codes.

   Reviews the revised code structure for domiciliary, rest home, and custodial care services. It explains the broader impact of the changes on service complexity and patient setting.

5. Change #5: CPT adds 99399 and 99340 to differentiate care plan oversight in the domiciliary or rest home setting.

   Explains the creation of a new oversight reporting category for domiciliary, rest home, and home care settings. The section also contrasts this area with existing nursing facility oversight reporting.