Neurosurgery Coding Alert

Question: Our neurosurgeon was recently called into the hospital to take over the care of a patient when her previous doctor had to leave town unexpectedly. He began care three days into her eight-day hospital stay. How should I code for the neurosurgeon's first inpatient visit with her?

Illinois Subscriber

Answer: CPT states that admitting physicians should use the initial hospital care codes "to report the first hospital inpatient encounter with the patient." For initial inpatient encounters by physicians other than the admitting physician, you should use initial inpatient consultation codes 99251-99255 or subsequent hospital care codes 99231-99233, as appropriate.
 
In your case, it sounds as if your physician accepted the transfer of the patient's care in advance, and therefore he was not performing a consultation. You would use one of the subsequent hospital care codes, which represent both new and established patients, so even if the surgeon had never met the patient before, you would still bill the 99231-99233 series.