CPT 99304, CPT 99305, CPT 99306, CPT code 99304, CPT code 99305, CPT code 99306, 99304 CPT code, 99305 CPT code, 99306 CPT code, 99304 CPT, 99305 CPT, 99306 CPT

CPT 99304 – CPT 99306 (Initial Nursing Facility Care)

New or Established Patient Comprehensive Nursing Facility Assessments

CPT 99304 Description: There are 3 key components that must be met in order to report code 99304 when an Evaluation and Management service level for a patient receiving initial nursing facility care is selected. The 3 components are in addition to the medical necessity for performing any procedures.

CPT 99305 Description: There are 3 key components that must be met in order to report code 99305 when an Evaluation and Management service level for a patient receiving initial nursing facility care is selected. The 3 components are in addition to the medical necessity for performing any procedures.

CPT 99306 Description: There are 3 key components that must be met in order to report code 99305 when an Evaluation and Management service level for a patient receiving initial nursing facility care is selected. The 3 components are in addition to the medical necessity for performing any procedures.

Revised Guidelines for CPT 99441, 99442 & 99443 (2021)

Updated May 9, 2020, with information from the 4/30/20 rule CMS will pay for phone calls using codes CPT 99441—99443. The 4/30/20 rule adds these to the telehealth list and increased payment for these services CMS continues did not add CPT 98966–98968 to the telehealth list These codes previously had a non-covered status Physicians, nurse…

5 New HCPCS Codes

Q9991 Injection, buprenorphine extended-release (Sublocade), less than or equal to 100 mg Q9992 Injection, buprenorphine extended-release (Sublocade), greater than 100 mg Q9993 Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg Q9994 In-line cartridge containing digestive enzyme(s) for enteral feeding, each Q9995 Injection, emicizumab-kxwh, 0.5 mg For more information: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10624.pdf https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2018Downloads/R4063CP.pdf https://www.aapc.com/blog/41801-5-new-hcpcs-codes-effective-july-1

Humana differ from AMA CPT Coding guidelines

The below list of code combinations that Humana has determined are not appropriately reported together with a modifier 59 and which differ from AMA CPT coding guidelines. Modifier 59 Edits (as of October 31, 2008) Humana utilizes the following code-editing logic: CPT code 63042 appended with modifier 59 will not be reimbursed when submitted with…

CPT Codes For Digitally Stored Data and Remote Physiologic Monitoring Services

CPT 99453 Description: The provider sets up and trains the patient on the use of remote physiologic monitoring equipment. CPT 99454 Description: Use CPT 99454 for every 30 days of equipment supply and monitoring. The provider supplies the patient with remote physiologic monitoring equipment and receives daily recordings and/or programmed alerts. CPT 99091 Description: CPT…

CPT codes for MICROBIOLOGY

The AMA added new codes for the infectious testing for gastrointestinal pathogens (e.g., salmonella, shigella, etc.) which previously did not have a separate code for these infectious molecular methodologies. Previously, the code set contained no specific code to report the actual gene associated with HPV for high risk or low risk HPV. AMA deleted those…

CPT 99381 – CPT 99387 (New Patient Preventive Medicine Services)

CPT 99381 Description: A baby is visited by a provider for a well baby visit (for babies younger than 1). CPT 99382 Description: A child (new patient) between 1 and 4 years old is visited by a provider for a well patient visit. CPT 99383 Description: A child (new patient) between 5 and 11 years…

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