Solve the admit-on-day-1, visit-on-day-2 coding dilemma at last. Consider the following scenario offered by Dolly Cooper, CMC, and Brenda Mantia, CMC, with Cardiovascular Consultants, a 10-physician practice in Shreveport, La. Scenario: What would you do? Would you choose May 1 or May 2 as the date of service for the cardiologist's visit? Match Your DOS Choice to the Authorities' Solution: Support: The key here is that so-called "admit" codes 99221-99223 don't say anything about admission in their descriptors. They instead describe initial hospital care and require a face-to-face visit in the inpatient setting. Bonus tip: See How Same-Date, 2-Date Coding Differs The date of service for the initial hospital care is also important in determining proper coding for the cardiologist's E/M services. Initial hospital care codes 99221-99223 include all E/M services connected to a hospital admission when provided on the same date of service, Morrow says, stressing the importance of the "same date of service." The rules: CPT guidelines for "Initial Hospital Care" similarly instruct that "When the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service (e.g., hospital emergency department, observation status in a hospital, physician's office, nursing facility), all evaluation and management services provided by that physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission." Test Run: Apply the Rule 2 Ways You not only need to know where to locate the rules, but also how to apply them. Here's how the rule applies when the cardiologist sees the patient (1) on the same date in the office and hospital, and (2) in the office on the first date and in the hospital on the second. 1. Same date: 2. Back to the two-date scenario: If the cardiologist sees the patient in the office on May 1, admits the patient, and then sees the patient for the first time as an inpatient at 2:00 a.m. on May 2, you may report both the May 1 office visit and the initial hospital care on May 2, says Morrow. So knowing to use the second date for your 99221-99223 claim allows you to be reimbursed for both an office visit and initial hospital care. Bottom line: