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Changes to E/M Codes in 2006 - Nursing Home Visits

Betsy Nicoletti

The 2006 CPT book from the AMA brought changes to nursing home codes.  Both comprehensive nursing home assessments and subsequent nursing home visit procedure codes were deleted and redefined.  The discharge visit codes are the same.

The previous comprehensive nursing home assessment codes described three separate services:  Annual assessment (99301), major, permanent change in status (99302) and admission or re-admission (99303).  Many physicians did not understand that these three codes didn't represent three levels of admission.  There is now a new code for the annual nursing home assessment, 99318.  There are three admission codes, 99304--99306.

The documentation requirements for these admissions mirror the level of documentation for hospital admissions in history and exam.

The three subsequent nursing home visits are replaced four levels of service for subsequent visits.

The documentation requirements for each level are:

There is no change to discharge services.
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