Orthopedic Coding Alert

Reader Question:

Report Initial Hospital Care for Admits Only

Question: I was recently called into the hospital to take over the care of a patient who was unable to get along with her previous orthopedist. I began my care two days into her four-day hospital stay. How should I code for my first inpatient visit with her?

Illinois Subscriber
 
Answer: In your case, it sounds as if you were not performing a consultation, so you should use one of the subsequent hospital care codes. These codes represent both new and established inpatient visits, so even if you have never met the patient before, you would still bill the 99231-99233 series (Subsequent hospital care).
 
CPT states that the initial hospital care codes "are used to report the first hospital inpatient encounter with the patient by the admitting physician. For initial inpatient encounters by physicians other than the admitting physician, see initial inpatient consultation codes (99251-99255) or subsequent hospital care codes (99231-99233) as appropriate."
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Orthopedic Coding Alert

View All