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Pulmonology Coding Alert

Reader Question:

Assign 99231-99233 for Subsequent Hospital Care

Published on Mon Feb 23, 2004

Question: Medicare frequently denies our claims for subsequent hospital care. Do you have any tips to help us get paid?

Idaho Subscriber Answer: Make sure you report subsequent hospital care using the right codes:

99231 -- Subsequent hospital care ... problem-focused interval history; problem-focused exam; straightforward or low-complexity decision-making
99232 -- ... expanded problem-focused interval history; expanded problem-focused exam; moderate-complexity decision-making
 99233 -- ... detailed interval history; detailed exam; high-complexity medical decision-making Also, remember that subsequent care covers such services as history, review or order of diagnostic studies, and evaluation of any change in the patient's status. The pulmonologist should also examine two of the patient's body systems. And your physician must document in detail the affected system, which is usually the respiratory system.
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