2023 CPT Evaluation and Management Coding Changes

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2023 CPT Evaluation and Management
Important Code and Guidelines Changes2023 CPT
Evaluation and Management Important Code and
Guidelines Update

• By Kate Gilman, CPC, CPCO

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Presenter
_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.

• Phone [phone]
• Email kateg_at_medicalworldsolutions.com
• Website https//medicalworldsolutions.com

2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Our goal
_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.

• Review deleted codes for Hospital Observation
  services.
• Review revised codes for Hospital Inpatient and
  Observation care services guidelines.
• Review deleted Consultation codes.
• Review revised Emergency Department services
  codes and guidelines.
• Review deleted codes for Nursing facility
  services.

2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Our goal
_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.

• Review revised codes for nursing facility
  services and guidelines.
• Review deleted Domiciliary, Rest home or
  custodial care services codes.
• Review deleted codes for Home or Residence
  services.
• Review revised codes for Home or Residence
  services and guidelines.

2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Hospital Observation services

• 99217- Observation care discharge day
  management - DELETED.
• 99218- Initial observation care, per day, low
  complexity- DELETED.
• 99219- Initial observation care, per day,
  moderate complexity- DELETED.
• 99220- Initial observation care, per day, high
  complexity- DELETED.
• 99224- Subsequent observation care, per day, low
  complexity- DELETED.
• 99225- Subsequent observation care, per day,
  moderate complexity- DELETED.
• 99226- Subsequent observation care, per day, high
  complexity- DELETED.

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Hospital Observation services

• Instead of 99218, 99219, 99220
• 99221- Initial hospital care, per day, low
  complexity
• 99222- Initial hospital care, per day, moderate
  complexity
• 99223- Initial hospital care, per day, high
  complexity

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Office or other outpatient Consultation codes

• These codes are used to report consultations that
  are provided in the office or other outpatient
  site, including the home or residence, or
  emergency department.

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Nursing Facility ServicesCodes

• These codes are used to report evaluation and
  management services to patients in nursing
  facilities and skilled nursing facilities.
• Place of service should indicate the type of
  facility where the service is performed.

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Nursing facility discharge services

• 99315- Nursing facility discharge management 30
  minutes or less total time on the date of the
  encounter
• 99316- more than 30 minutes total time on the
  date of the encounter

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Domiciliary, Rest home, or custodial care services

• 99334- Domiciliary or rest home visit for the
  evaluation and management of an established
  patient, straightforward complexity- DELETED
• 99335-Domiciliary or rest home visit for the
  evaluation and management of an established
  patient, low complexity- DELETED
• 99336- Domiciliary or rest home visit for the
  evaluation and management of an established
  patient, moderate complexity- DELETED
• 99337- Domiciliary or rest home visit for the
  evaluation and management of an established
  patient, high complexity- DELETED
• 99339 and 99340- Individual physician supervision
  of a patient (patient not present) in home,
  domiciliary or rest home (eg, assisted living
  facility) requiring complex and multidisciplinary
  care modalities- DELETED

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Home or Residence Services Codes

• Private residence
• Temporary lodging
• Short-term accommodations
• Assisted living facility
• Group home
• Residential substance abuse treatment facility

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Prolonged Service w/direct patient contact

• 99354- Prolonged service(s) in the outpatient
  setting requiring direct patient contact beyond
  the time of the usual service first hour DELETED
• 99355- Prolonged service(s) in the outpatient
  setting requiring direct patient contact beyond
  the time of the usual service each additional 30
  minutes DELETED
• 99356- Prolonged service in the inpatient or
  observation setting, requiring unit/floor time
  beyond the usual service first hour DELETED
• 99357- Prolonged service in the inpatient or
  observation setting, requiring unit/floor time
  beyond the usual service each additional 30
  minutes DELETED

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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Prolonged service

• 99417 Prolonged outpatient evaluation and
  management service(s) time with or without direct
  patient contact beyond the required time of the
  primary service when the primary service level
  has been selected using total time, each 15
  minutes of total time- outpatient setting
• 993X0 Prolonged inpatient or observation
  evaluation and management service(s) time with or
  without direct patient contact beyond the
  required time of the primary service when the
  primary service level has been selected using
  total time, each 15 minutes of total time-
  inpatient setting

_at_2023, Kate Gilman. All Rights Reserved. Not for
distribution.
2023 CPT Evaluation and Management Important Code
and Guidelines Changes
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2023 CPT Evaluation and Management Important Code
and Guidelines Changes