Advanced Search

Pediatric Coding Alert

Reader Question:

Office Visit

Published on Tue May 01, 2001

Question: Our office recently had a patient for whom we performed a complete history and examination, including lab work. We decided to admit the patient, who subsequently arrived at the hospital and was evaluated by the specialist but never admitted. Our office billed 99222 for the admission because we did all the paperwork and contacted everyone required. Was this correct?

Louisiana Subscriber

Answer: In this situation you may not bill an admission because the patient was, in fact, not admitted. You should use an office visit code, possibly a 99214 or 99215 for an established patient or 99204 or 99205 for a new patient. The documentation in the chart should clearly describe the work undertaken as well as the level of examination and complexity of the visit.
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

Pediatric Coding Alert

View All