Pulmonology Coding Alert

Question: A patient presented in the office for asthma exacerbation, but got admitted the next day for worsening asthma. What code should I report for each day?

Maine Subscriber

Answer: If you performed an E/M in the office for asthma exacerbation one day, and the patient gets admitted to the hospital the following day, you can bill for each service. You should report the appropriate outpatient E/M code (99212-99215) for the office visit, and an initial hospital visit code (99221-CPT 99223 ) for the admission, supported by sufficient documentation. If both services occurred on the same day, you would forego the office visit to report the initial hospital care. Remember, only one visit per patient per physician per day is permitted for reimbursement.