Neurology & Pain Management Coding Alert

Question: Can a neurologist use 99233 instead of 99238 to discharge a patient? I know that 99233 pays more, but it seems that using this code would not comply with coding rules as it indicates that the patient is still very ill.

Washington, D.C., Subscriber

Answer: Laurie Castillo, MA, CPC, president of Physician Coding and Compliance Consulting, a physician consulting firm in Manassas, Va., and a coding expert in neurology, says that 99238 (hospital discharge day management; 30 minutes or less) and 99239 (hospital discharge day management; more than 30 minutes) are the only correct codes to use because they are to be used specifically for hospital discharge day management. Code 99233 is to be used specifically for evaluation and management (E/M) subsequent hospital care. Using 99233 may be construed as fraud if the service was not rendered and the code was used to gain reimbursement.