Practice Management Alert

CPT 2008 will add reference times to several E/M code categories that did not previously include them -- specifically nursing facility care (99304-99310) and annual nursing facility assessments (99318). The addition of a reference time means that, when necessary and supported by documentation, you may select an E/M service level using time, rather than the history, exam and medical decision-making key components, as the primary deciding factor for billing these services. You-ll have to await CMS guidance to see if you can report these new codes simultaneously with prolonged service codes when time becomes prolonged and is also the primary coding factor for a visit in a nursing facility.