CPT® Hits Reset on Inpatient, Observation Codes
Here’s what you’ll use instead of 99217 next year. If you thought the ED codes contained the only changes made to evaluation and management (E/M) coding for 2023 … think again. In a nutshell: As with office/outpatient E/M codes in 2021, the American Medical Association (AMA) is changing descriptors for (or outright deleting) several code sets in the other E/M sections of CPT®. In some cases, these changes mirror what the AMA did in 2021; but there are some differences. “Overall, the CPT® Editorial Panel worked to, again, create revisions to the E/M code descriptors and guidelines that met their objective to decrease the administrative burden of excessive documentation whenever possible,” says Mary I. Falbo, MBA, CPC, CEO of Millennium Healthcare Consulting, Inc. in Lansdale, Pennsylvania. Read on to see what E/M coding changes you’ll have to observe when CPT® 2023 takes effect Jan. 1, 2023. Say Goodbye to Original Per-Day Observation Codes In one stroke, CPT® is getting rid of its per-day observation codes — but not the concept of observation services. What’s being deleted? CPT® 2023 will delete the following codes: What should I do? CPT® 2023 will include the following coding directive: In addition to the above deletions, CPT® also rids itself of 99217 (Observation care discharge day management…) in 2023. According to CPT®, “99217 has been deleted. To report observation care discharge services, see 99238, 99239.” Discharge Services Moved Under 99238, 99239 Reporting discharge services will be different next year, as CPT® created descriptors that will allow for one set of codes to be used for hospital inpatient or observation discharge day management. What’s being deleted? CPT® 2023 will delete the descriptors for the following codes: What’s being added? CPT® 2023 will add these descriptors for the above-listed codes: Impact: CPT® is putting hospital inpatient or observation discharge day management services into the same code descriptors. You’ll use 99238 and 99239 for both these types of discharges. CPT® Gives Observation Big Revisions CPT® 2023 will retain its original initial per-day hospital care codes, but they will be vastly different and more inclusive of observation services. What’s being deleted? CPT® 2023 will delete the descriptors for the following codes: What’s being added? CPT® 2023 will add these descriptors for the above-listed codes: Impact: As the descriptors indicate, you will use 99221 through 99223 for all your multi-day hospital inpatient or observation services. For these services, you will choose from the revised 99238 or 99239 codes for discharge. As with most of the 2023 E/M changes, Falbo says these changes should make things easier for coders and providers, “since there will be consistency in both outpatient and inpatient, where MDM [medical decision making] and time are the key factors.” There will also be “less administrative burden on meeting specific requirements for history and exam,” she says. Remember: Unlike the ED E/M codes, the revised inpatient and observation code family can be chosen based on either MDM or time. Also, with the new requirement for only a medically appropriate history and physical exam, that pesky prior requirement for three out of three past, family, and social history (PFSH) will no longer hinder your observation code selections. Get Ready for Single-Day Observation/Inpatient Code Combo CPT® 2023 will hold onto its single-day observation codes What’s being deleted? CPT® 2023 will delete the descriptors for the following codes: What’s being added? CPT® 2023 will add these descriptors for the above-listed codes: Impact: As the descriptors indicate, 99234-99236 will be your one-stop shop for one-day hospital inpatient or observation care admission and discharge services.
, but there are some changes. Much like the revisions of 99221 through 99223, these revisions will make the codes more inclusive.
