Outpatient Facility Coding Alert - 2015 Issue 4
Reader Question: Save 99318 for Annual Assessments
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Article Overview
This article addresses a common nursing facility coding question about distinguishing an annual assessment from a problem-oriented follow-up visit. It is aimed at coders and billing staff who need to interpret provider intent, documentation components, and the appropriate level of nursing facility evaluation and management service. The discussion focuses on the general selection of the correct nursing facility E/M code for the encounter type described in the question.
Why This Topic Matters
Choosing the right nursing facility E/M service depends on the nature of the encounter and the documented work performed. Misclassifying a problem-oriented visit as an annual assessment can lead to inaccurate claim reporting and coding errors.
What You Will Learn
- How to distinguish an annual nursing facility assessment from a problem-oriented visit
- How documentation elements relate to nursing facility E/M level selection
- How encounter intent affects reporting for nursing facility care services
- How to review a nursing facility follow-up visit for appropriate E/M coding
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Nursing facility practice administrators
- Physician office staff
Codes Discussed
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