nursing home visit cpt codes 2023

How E&M Code Changes in 2023 Will Impact Nursing Facility Services

• By Colleen (Deighan) Ejak, RHIA, CCS, CCDS-O
• October 3, 2022

This category of E&M services will have three subcategories instead of the current four.

EDITOR’S NOTE:  The American Medical Association (AMA) announced major revisions to Evaluation and Management (E&M) Services for Jan 1, 2023. The E&M categories that will undergo revision in 2023 include inpatient and observation care services, emergency department services, consultations, nursing facility services, home and residence services, and prolonged services.

For 2023, revisions to the E&M category for nursing facility services include a deleted code, revised codes, and broad guidelines revisions. In 2023, this category of E&M services will have three subcategories instead of the current four: Initial nursing facility care, subsequent nursing facility care and nursing facility discharge services. The nursing facility annual assessment code, 99318, is deleted with parenthetical reference to report this service with the subsequent nursing facility care codes, 99307-99310. 

The subsection guidelines now indicate that these services are reported for E&M services to patients in nursing facilities and skilled nursing facilities. These codes should also be used to report evaluation and management services provided to a patient in a psychiatric residential treatment center and immediate care facility for individuals with intellectual disabilities.

Regulations pertaining to the care of nursing facility residents govern the nature and minimum frequency of assessments and visits. These regulations also govern who may perform the initial comprehensive visit.

Revisions to the remaining E&M categories, including Nursing Facilities Services, align the 2023 E&M codes with the 2021 revisions made to the office and other outpatient services codes. The three key components, history, exam, and medical decision making are no longer required for reporting these services. A medical appropriate history or physical as determined by the physician or APP should be documented; the level of service is determined solely be the level of medical decision making (MDM) or time. The AMA redefined what “time” includes for selection of the level of service, time is now the total time on the date of the encounter and includes both face-to-face time and non-face-to-face time.  Activities included in total time are the following:

• Preparing to see the patient
• Obtaining/reviewing separately obtained history
• Performing examination
• Counseling and educating the patient/family
• Ordering medications, tests, or procedures
• Referring and communicating with other health care professionals
• Documenting in the electronic health or other health record
• Independently interpreting results and communicating results to patient/family
• Care coordination (when not reported separately)

The revised guidelines state a high-level MDM-type specific to initial nursing facility care by the principal physician or other qualified health care professional is defined as multiple morbidities requiring intensive management. Moreover, it is also defined as a set of conditions, syndromes, or functional impairments that are likely to require frequent medication changes or other treatment changes and/or re-evaluations.

The patient is at significant risk of worsening medical (including behavioral) status and risk for (re)admission to a hospital. The principal physician is the physician who oversees the patient’s care as opposed to other physicians or qualified health care professionals who may be furnishing specialty care.

Initial nursing facility care codes 99304, 99305, 99306 may be used once per admission, per physician or other qualified health care professional, regardless of length of stay. They may be used for the initial comprehensive visit performed by the principal physician or other qualified health care professional. Skilled nursing facility initial comprehensive visits must be performed by a physician. Qualified health care professionals may report initial comprehensive nursing facility visits for nursing facility level of care patients, if allowed by state law or regulation. An initial service may be reported when the patient has not received any face-to-face professional services from the physician or other qualified health care professional or another physician or other qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice during the stay.

I have shared the code revisions for nursing facility services and a few of the key guideline revisions. If your providers see patients in nursing facilities a complete review and understanding of the coding and reporting guidelines is essential to proper payment. Coding professionals should be aware of these revisions because they will affect reimbursement. Consider reviewing current documentation practices and revise documentation templates not needed for patient care. Also consider how your providers can track total time in to correctly report and bill for these services.

Programming note: Listen to Colleen Deighan’s live reporting on E&M updates today during Talk Ten Tuesdays with Chuck Buck and Dr. Erica Remer at 10 Eastern.

References :

American Medical Association 2023 E&M Code and Guideline changes, available at: 2023 CPT E&M descriptors and guidelines (ama-assn.org)

Billing and Coding: Evaluation and Management Services in a Nursing Facility, available at https://www.cms.gov/medicare-coverage-database

AMA CPT® Professional 2022 Codebook © 2021 American Medical Association

AMA CPT® Assistant, August 2022, Pg 3,  E&M Revisions for 2023: An Overview

• TAGS: AMA , Coding , E&M , Inpatient , Observation , Skilled Nursing Facilities (SNF)

Colleen (Deighan) Ejak, RHIA, CCS, CCDS-O

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April 13, 2024

2023 CPT® E/M Changes

Ready to learn about the 2023 CPT® E/M changes? There is a significant update to the Evaluation and Management (E/M) section of the CPT® book. There are 25 codes that are going away. There are revisions to the introductory guidelines related to five different categories of codes. Prolonged services are getting yet another overhaul. This article discusses the American Medical Association’s E/M changes, but does not include how Medicare is proposing to accept–or not–these codes and policies. That will be addressed in a later article.

Here are the codes that are being deleted.

• Hospital observation services codes 99217—99220, 99224–99226
• Consultation codes 99241, 99251
• Nursing facility service 99318
• Domiciliary, rest home (eg, boarding home), or custodial care services, 99324—99328, 99334-99337, 99339, 99340
• Home or resident services code 99343
• Prolonged services codes 99354—99357

Initial and subsequent services

There is a new section titled initial and subsequent services which applies to hospital inpatient,  observation care and nursing facility codes. It applies to both new and established patient visits. The AMA says,

“For the purpose of distinguishing between initial or subsequent visits, professional services are those face-to-face services rendered by physicians and other qualified health care professionals who may report evaluation and management services. An initial service is when the patient has not received any professional services from the physician or other qualified health care professional or another physician or other qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, during the inpatient, observation, or nursing facility admission and stay.” [1]

• These codes are used by physicians and other qualified health care professionals who have E/M services in their scope of practice
• It explains the rules for physicians and other qualified health care professionals who are working in the same specialty and subspecialty in the same group practice. During an inpatient, observation, or nursing facility stay, the group may bill only one initial service, and follow up services are billed with subsequent visits. This is not a change in how groups are reporting inpatient or observation services. When partners are covering for one another, the practitioner who does the initial service bills for the initial service and on subsequent days covering physicians report a subsequent visit. It is aligned with the Medicare rule that physicians in the same group of the same specialty should bill and be paid as if they were one physician.

Selecting a level of service using 2023 CPT® E/M changes

As expected, the AMA has extended the framework for code selection for office and outpatient visits that was implemented in 2021 to the remainder of E/M services that were selected based on history, exam, medical decision making or time.

The change affects these services:

• Hospital inpatient and observation care services (one set of codes will be used for both inpatient and observation)
• Consultation services
• Emergency department services (time may not be used as a factor when selecting an ED visit)

Nursing facility services

Home or residence services.

For the categories of codes listed above, the level of E/M service may be selected by the medical decision-making or time. (Time is not a factor in selecting ED visits.) Code selection will be based on the three elements of medical decision making which are: the number and complexity of problems that are addressed during the encounter, the amount and/or complexity of data to be reviewed and analyzed, and the risk of complications or morbidity or mortality of patient management. This article provides an overview of the 2023 CPT® E/M Changes. There are additional resources on CodingIntel that describe selecting the level of service . Those resources will be updated to reflect the changes that the AMA made in their discussion of medical decision-making.

Hospital inpatient and observation care services

With the deletion of observation codes 99217—99220, and 99224—99226, the same codes will be used to report services for patients who are in observation or are inpatients. There are two sets of codes. One set is for use when the patient is admitted and discharged on the same calendar day, 99234–99236. And the other set is for patients whose stay is longer than a single calendar day. These are 99221–99223 for the initial service, 99231—99233 for subsequent visits and 99238 and 99239 for discharge services.

CPT® says that when the conditions for a consultation are met, codes 99252-99255 may be reported by a consulting physician in the inpatient setting. Medicare, of course, does not recognize these codes and many private insurances also stopped recognizing these codes.

In the guidelines for this section, CPT® repeats that when advanced practice nurses and physician assistance are working with physicians, they are considered to be working in the exact same specialty and subspecialty. The AMA also has changed its guidance on admitting a patient from another site of service. It is unlikely that Medicare or other players will follow this guidance but this is what the AMA says.

“When the patient is admitted to the hospital as an inpatient or to observation status in the course of an encounter in another site of service (eg, hospital emergency department, office, nursing facility), the services in the initial site may be separately reported. Modifier 25 may be added to the other evaluation and management service to indicate a significant, separately identifiable service by the same physician or other qualified health care professional was performed on the same date.” [2]

The AMA also notes that if a patient transitions from inpatient or observation or from observation to inpatient, it does not constitute a new stay. That is, don’t bill an additional initial service if the patient’s status changes.

Admission and discharge on the same calendar date

Codes 99234—99236 are used for hospital inpatient or observation care and include the admission and discharge on the same date, whether the patient is an inpatient or in observation level care. CPT states that in order to report these services, there must be two encounters, the admission and discharge. The documentation should reflect that the patient was seen twice. While CMS is recognizing and paying for these services, in order to report them the patient must be in the facility for >8 hours. This is unchanged CMS policy, but is not a CPT rule.

The Physician Final Rule had a table indicating what codes to bill when the patient was and wasn’t in the facility for 8 hours or more. Below, is the table reproduced with an additional column for CPT rules and codes added to the descriptions in the CMS rule.

How do the 2023 CPT® E/M changes affect reporting consultation codes?

The two low level consult codes 99241 and 99251 are deleted. The comments in this section are considerably reduced from the 2022 book. CPT® clarifies two things that won’t come as a surprise for most people. Consultations must be requested by another health care professional, not the patient’s family or lawyer or a non-clinical social worker. And the consultant’s opinion and any services that were ordered or performed must be communicated by written report to the requesting physician or other qualified healthcare professional.  CPT® says to use codes 99242-99245 for service in the office or other outpatient setting including home and the emergency department. Codes 99252-99255 are used in hospital inpatients, for observation level patients, for residents in a nursing facility and for patients in a partial hospital setting. A consult is only used once per stay per specialty and group.

Consults require a request from another health care professional or appropriate source and a written report. Document both of these in the consult note. The concept of transfer of care is removed from the 2023 CPT book and no longer is a lens with which to evaluate consults.

Medicare does not intend to change its policies and does not recognize these codes.

Emergency department services

ED visits are not defined as new or established patients. When selecting a level of service in 2023, use medical decision-making. Time is not a factor in ED visits. Code 99281 has a descriptor change. It is now defined as “Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional.” This makes it like code 99211, that does not require the presence of a physician or other qualified health care professional.  However, a medical practice may not bill 99281 for services performed by a hospital employed nurse, and Medicare does not allow incident to services in a facility. It is difficult to see when a medical group would report 99281.

The codes in this section are used for patients in nursing facilities, skilled nursing facilities, psychiatric residential treatment centers, and immediate care facilities for individuals with intellectual disabilities. The editorial comments are significantly revised from the 2022 book. The AMA describes the principal physician as the admitting physician and is the clinician who oversees the patient’s care. Other physicians and qualified health care professionals may also see the patient.

“Modifiers may be required to identify the role of the individual performing the service.” [3]  

Although that CPT® book doesn’t say this, I assume the modifiers in question would be HCPCS modifiers that identify the principal physician, AI, or a nurse practitioner or physician assistant as performing the service.

The AMA notes that there is a high-level medical decision-making specific to initial nursing facility cares by the principal physician or other qualified health care professional. This is in the element related to the number and complexity of problems addressed at the encounter. It is:

“ Multiple morbidities requiring intensive management: A set of conditions, syndromes, or functional impairments that are likely to require frequent medication changes or other treatment changes and/or re-evaluations. The patient is at significant risk of worsening medical (including behavioral) status and risk for (re)admission to a hospital. The definitions and requirements related to the amount and/or complexity of data to be reviewed and analyzed and the risk of complications and/or morbidity or mortality of patient management are unchanged.◄” [4]

That is, the AMA is adopting a unique definition in the number and complexity of problems addressed for initial nursing facility services. Note that the other two elements are unchanged for initial nursing facility services.

The AMA says that the initial nursing facility services may be used once per admission per physician or other qualified health care professional, regardless of the length of stay. The AMA aligns itself with Medicare rules in saying that the initial comprehensive visit in a skilled nursing facility must be done by a physician. In a nursing facility (the distinction is not in a skilled nursing facility) the AMA says qualified health care professionals may report the initial comprehensive nursing facility visit if allowed by state law or regulation.

Initial services by physicians and other qualified healthcare professionals who are not the admitting or principal physician for the patient in the nursing home may be reported with initial nursing facility or consultation codes according to the CPT® book.

The two nursing facility discharge services, 99315 and 99316 are time-based codes. They include all of the time spent on the day that the physician or other qualified health care professional has a face-to-face visit with a patient. Report the service on the day that the practitioner sees the patient, even if it is not the day that the patient is discharged from the facility.

Domiciliary, rest home or custodial care services codes are now deleted. To report services to patients in those facilities, use the home or residence services codes. For new patients, these are codes 99341, 99342, 99344, 99345. Code 99343 is deleted. There are four levels of new patient home or resident services. There are also four levels of established patient home or residence services, using codes 99347—99350. The AMA states that if selecting a code based on time, you may not include travel time.

Prolonged care codes receive a lot of attention in the 2023 CPT® E/M changes

CPT® is deleting prolonged codes 99354, 99355, 99356, and 99357. These were face-to-face prolonged care codes that could be used with office/outpatient codes or inpatient, observation or nursing facility. CPT® is keeping non-face-to-face prolonged care codes 99358 and 99359 for when the services are performed on a date other than a face-to-face visit. There is a long list of services which may not be reported on the same date, and you may never double count time spent, so there a long list of services for which CPT® says don’t include the time of non face-to-face prolonged care when you’re reporting these other care management services. As a sidenote, CMS is proposing to give codes 99358 and 99359 a status indicator of invalid, which would make them non-payable for Medicare patients.

CPT® is revising the editorial comments for prolonged clinical staff codes 99415 and 99416. These codes are also not payable by Medicare.

Existing prolonged care code 99417 which currently may be used only with 99205 and 99215 will be reported with  outpatient consult code 99245, home visit codes 99345 and 99350, and cognitive assessment code 99483 in 2023.

The AMA is developing a new prolonged care code, which is not released in its July guideline. The placeholder code that the AMA is using is 993X0 for additional 15-minute increments of time with or without patient contact to be used with hospital codes 99223, 99233, and 99236, and consult code 99255, and nursing facility codes 99306 and 99310. The prolonged services codes may now only be used with the highest level code in the category or subcategory. It won’t surprise you to learn that in the Medicare proposed rule, they are developing additional HCPCS codes for prolonged care, and will not recognize the CPT® codes.

The 2023 CMS Proposed Physician Rule Webinar will describe the policy proposals in the 2023 Proposed Physician Rule. At the end of the session, participants will be able to:

• Describe the timeline for comments and the final rule
• List policy changes that will affect their practices in the next year

Article References:

[1] https://www.ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf   p. 4, Accessed July 5, 2022

[2] Ibid p. 23

[3] Ibid p. 31

[4] Ibid p. 31

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Last revised July 31, 2023 - Betsy Nicoletti Tags: CPT updates

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Coding Physician Visits in Skilled Nursing Facilities/Nursing Facilities

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As of April 22, due to the COVID-19 public health emergency , CMS is waiving the requirement in 42 CFR 483.30 for physicians and non-physician practitioners to perform in-person visits for nursing home residents and allow visits to be conducted, as appropriate, via telehealth options. Prior to this, telehealth was only available for established patient visits.

Coding for Skilled Nursing Facility

• To be reported when the MD, DO, OD visits the patient in the Skilled Nursing Facility.
• Place of Service is 13.
• Initial Visit whether patient is new or established 99304, 99305, 99306
• Subsequent Skilled Nursing Facility visits performed in person or via telehealth: 99307, 99308, 99309, 99310

Coding for Nursing Home Visits

• To be reported when the MD, DO, OD visits the patient in a Nursing Home.
• Place of service is 13
• New Patient: 99324, 99325, 99326, 99327, 99328
• Established Patient: 99334, 99335, 99336, 99337
• Modifier -25

Note: When billing an intravitreal injection (or any minor surgery) the same day as an encounter, consider the definition of modifier -25 and although medically necessary, if the established patient exam is performed solely to confirm the need for the injection, the exam is not separately billable.

Coding for Home Visits

• To be reported when the MD, DO, OD visits the patient at their home.
• Place of service is 12
• New Patient: 99341, 99342, 99343, 99344, 99345
• Established Patient: 99347, 99348, 99349, 99350

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List of CPT/HCPCS Codes

We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain designated health services (DHS) categories or that may qualify for certain exceptions. We update the Code List to conform to the most recent publications of CPT and HCPCS codes and to account for changes in Medicare coverage and payment policies. Code List updates for years 2022 and earlier were published in the Federal Register as an addendum to the annual Physician Fee Schedule final rule. 

Beginning with the Code List effective January 1, 2023, updates are published solely on this webpage.  On or before December 2 nd of each year, we will publish the annual update to the Code List and provide a 30-day public comment period using www.regulations.gov . To be considered, comments must be received within the stated 30-day timeframe. We anticipate that most comments will be addressed by April 1 st ; however, a longer timeframe may be necessary to address complex comments or those that require coordination with external parties. If no comments are received, in lieu of a comment response, we will publish a note below the applicable Code List year stating so. 

2024 Annual Update to the Code List

Below you will find the Calendar Year (CY) 2024 Code List published November 29, 2023 and a description of the revisions for CY 2024, our response to comments on that Code List, and the updated CY 2024 Code List, which is effective January 1, 2024 unless otherwise indicated on the Code List.

• UPDATED list of codes effective January 1, 2024, published March 1, 2024 (all codes effective January 1, 2024 unless otherwise indicated on the Code List) (ZIP)
• List of codes effective January 1, 2024, published November 29, 2023 (ZIP)
• Annual Update to the List of CPT/HCPCS Codes Effective January 1, 2024 (PDF)

We received one comment related to the additions, deletions, and corrections to the codes on the Code List effective January 1, 2024. Our response to this comment is below. We also received one comment related to Medicare coverage for platelet-rich plasma treatments. We consider this comment to be outside the scope of the annual update. CMS does not respond to out of scope comments on the annual updates to the Code List. 

Comment : One commenter noted that, although most Hepatitis B vaccine codes are identified on the Code List as CPT/HCPCS codes to which the exception for preventive screening tests and vaccines at § 411.355(h) applies, the Hepatitis B vaccine associated with CPT code 90739 was not listed. The commenter requested that CPT code 90739 be added to the list of vaccine codes to which the exception for preventive screening tests and vaccines at §411.355(h) applies, effective retroactively to January 1, 2024.

Response : We agree with the commenter that the exception for preventive screening tests and vaccines at § 411.355(h) should apply to CPT code 90739 and are revising the Code List accordingly. The applicability of the exception for preventive screening tests and vaccines to CPT code 90739 is prospective only and effective on the date indicated on the UPDATED list of codes. 

In considering this comment, we also identified two CPT codes (90653 and 90658, both flu vaccines) that were inadvertently left off of the list of codes to which the exception for preventive screening tests and vaccines at § 411.355(h) should apply. Accordingly, we are adding these CPT codes to the list of codes to which the exception at § 411.355(h) applies, effective on the date indicated on the UPDATED list of codes.

2023 Annual Update to the Code List

Below you will find the Code List that is effective January 1, 2023 and a description of the revisions effective for Calendar Year 2023. 

• List of codes effective January 1, 2023, published December 1, 2022
• Annual Update to the List of CPT/HCPCS Codes Effective January 1, 2023, published December 1, 2022 (PDF)

The comment period ended December 30, 2022. We did not receive any comments related to the additions, deletions, and corrections to the codes on the Code List effective January 1, 2023. We received one (1) comment related to the supervision level required for specific services. We consider this comment to be outside the scope of the annual update. CMS does not respond to out of scope comments on the annual updates to the Code List. 

DHS Categories

The DHS categories defined by the Code List are:

• clinical laboratory services;
• physical therapy services, occupational therapy services, outpatient speech-language pathology services;
• radiology and certain other imaging services; and
• radiation therapy services and supplies.

The Code List also identifies those items and services that may qualify for either of the following two exceptions to the physician self-referral prohibitions: 

• EPO and other dialysis-related drugs (42 CFR § 411.355(g)).
• Preventive screening tests and vaccines (42 CFR § 411.355(h)).

NOTE: The following DHS categories are defined at 42 CFR §411.351 without reference to the Code List:

• durable medical equipment and supplies;
• parenteral and enteral nutrients, equipment and supplies;
• prosthetics, orthotics, and prosthetic devices and supplies;
• home health services;
• outpatient prescription drugs; and
• inpatient and outpatient hospital services.

Related Links

• List of codes effective January 1, 2022, published November 19, 2021
• List of codes effective January 1, 2021, issued December 1, 2020
• List of codes effective January 1, 2020, published December 2, 2019
• List of codes effective January 1, 2019, published November 23, 2018
• List of codes effective January 1, 2018, published November 3, 2017 [ZIP, 59KB]
• List of codes effective January 1, 2017, published November 16, 2016 [ZIP, 54KB]
• List of codes effective January 1, 2016, published October 30, 2015 [ZIP, 58KB]
• List of codes effective January 1, 2015, published November 13, 2014 (79 FR 67972) [ZIP, 54KB]
• List of codes effective January 1, 2014, published December 10, 2013 (78 FR 74791) [ZIP, 54KB]
• List of codes effective January 1, 2013, published November 16, 2012 (77 FR 69334) [ZIP, 54KB]

Ron Goldman's father and Alan Dershowitz react to O.J. Simpson's death

The death of O.J. Simpson drew immediate reaction around the country Thursday, renewing public interest in his era-defining 1995 murder trial — and reviving painful memories for the families who were close to the events.

Simpson was acquitted of murdering his ex-wife Nicole Brown Simpson and her friend Ron Goldman, capping off what legal analysts described at the time as the "trial of the century."

Goldman's father, Fred Goldman, told NBC News that the news of Simpson's death only further underscored his grief for his son, who was found stabbed to death outside Brown Simpson's home in Los Angeles on June 12, 1994.

"The only thing I have to say is, it’s just further reminder of Ron being gone all these years," Fred Goldman said in a phone interview. "It’s no great loss to the world. It’s a further reminder of Ron’s being gone."

In a subsequent statement sent to reporters, Fred Goldman and his daughter, Kim, said they were experiencing a "mixed bag of complicated emotions."

"We will continue to advocate for the rights of all victims and survivors, ensuring our voices are heard both within and beyond the courtroom," the Goldmans said in part. "Thank you for keeping our family, and most importantly Ron, in your hearts for the last 30 years."

Alan Dershowitz, the prominent lawyer who served as an adviser on Simpson's legal "Dream Team" alongside Johnnie Cochran and F. Lee Bailey, told NBC News that he was saddened to learn that his onetime client had died.

"I knew he was very sick, so I'm upset that he died," Dershowitz said. "I got to know him fairly well during the trial. It was one of the most divisive trials in American history along racial lines. He'll always be remembered for the Bronco chase, for the glove and for the moment of acquittal."

Simpson, 76, died of cancer, according to a statement from his family that was posted on X, the platform formerly known as Twitter.

"On April 10th, our father, Orenthal James Simpson, succumbed to his battle with cancer," the family said. "He was surrounded by his children and grandchildren. During this time of transition, his family asks that you please respect their wishes for privacy and grace."

Simpson's team of lawyers also included his friend Robert Kardashian, the late husband of reality television mogul Kris Jenner. The former Olympian and media personality Caitlyn Jenner, who was later married to Kris Jenner until their divorce in 2015, tweeted just two words in response to the news of Simpson's death: "Good Riddance."

Marcia Clark, a former Los Angeles deputy district attorney who was the lead prosecutor in the Simpson murder case, released a short statement: "I send my condolences to Mr. Simpson's family."

In an exclusive interview with NBC News, Keith Zlomsowitch — Brown Simpson's ex-boyfriend — said Simpson's death was a "relief." Zlomsowitch served as a pallbearer at her funeral.

"I think finally some sort of justice has been served, that he’s been taken from the earth," Zlomsowitch said. "So it doesn’t bring Nicole back. But it means he can no longer be who he is in this world."

Bob Costas, the sports broadcaster who worked with Simpson for years at NBC Sports covering the NFL, said he leaves behind “a complicated legacy, to put it mildly.”

“I can’t think of anyone historical or someone that we may have known where the first chapter and the second chapter of their lives are such a stark contrast … revered and then reviled,” Costas said on NBC’s “TODAY” show Friday. 

In the decades before he earned national infamy as a murder trial defendant, Simpson was best known as a decorated football star and sometime actor, appearing in "The Naked Gun" movie franchise.

The Buffalo Bills, the team Simpson spent most of his NFL career with, did not immediately post a comment on his death, but a fan account published a photo of him on Instagram.

Daniel Arkin is a national reporter at NBC News.

CINDY HUGHES, CPC, CFPC

Fam Pract Manag. 2023;30(2):35

Author disclosure: no relevant financial relationships.

EMERGENCY DEPARTMENT E/M CODING CHANGES

• Number and complexity of problems addressed,
• Amount and complexity of data reviewed and analyzed,
• Risk of complications, morbidity, or mortality of patient management.

It is important to learn the general MDM guidelines, which include definitions and directions to guide you in using the levels of MDM table .

Code 99281 is now described as a service that may not require a physician or other qualified health care professional, similar to code 99211 for E/M services provided to an established patient in an office or other outpatient setting.

Editor’s note: For information on the 2023 hospital and nursing home E/M visit coding changes, see the January/February issue of FPM .

ASSISTED LIVING AND HOME VISIT E/M CODING CHANGES

Diagnosis codes for difficulty with daily activities.

WE WANT TO HEAR FROM YOU

Send questions and comments to  [email protected] , or add your comments below. While this department attempts to provide accurate information, some payers may not accept the advice given. Refer to the current CPT and ICD-10 coding manuals and payer policies.

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