2006 Nursing Home Billing Codes Changes
As of January 2006, the previous used codes for nursing home visits (99301, 99302, 99303, 99311, 99312, 99313) have been eliminated. The codes below explain the current usage in terms of the history, physical, and management complexity. There is no difference between new and established patients for these visits.
Initial Nursing Facility Care |
99304 |
detailed/ detailed/ low |
|---|---|---|
99305 |
complex/complex/moderate |
|
99306 |
complex/complex/high |
*In a SNF the physician musts do this evaluation within 30 days of admission. In a NF this may be delegated to a PA not employed by the facility.
Subsequent Nursing Facility Care
(needs 2 out 3 of the components) |
99307 |
problem focused/pf/straightforward |
|---|---|---|
99308 |
expanded/expanded/ low |
|
99309 |
detailed/detailed/moderate |
|
99310 |
complex/complex/high |
|
Nursing Facility Discharge |
99315 |
30 minutes or less |
99316 |
more than 30 minutes |
|
| Annual Nursing Facility Assessment | 99318 |
detailed/complex/moderate complex |
It is important to remember that “when a patient is admitted to the nursing facility in the course of an encounter in another site of service, such as a hospital emergency department or physician’s office, all evaluation and management services provided by that physician in conjunction with that admission are considered part of the initial nursing facility care when performed on the same date as the admission or readmission.”
There are also new codes for Rest Home or Custodial Care Facilities. 99321-99333 have been deleted. Please review your 2006 CPT Manual for these updates.