Pulmonology Coding Alert
Nail Down E/M Rules When Admission Occurs
Question: Our pulmonologist saw a patient in the office, then admitted her to the hospital, but did not visit the patient in the hospital until the following day. Do we bill for the office visit, the hospital admission, or both? Codify Subscriber Answer: Because the physician does not see the patient until the following day in this scenario, you can now bill the office E/M service separately from the hospital visit. So, you can report 99201-99215 on the first day and 99221-99223 on the second. Why? The descriptors for 99221-99223 state that they are for hospital care per day (italics added). So, you can bill for the previous day's E/M service separately from the hospital visit. And if the patient stays in the hospital longer than the initial day, you can bill a code from the 99231-99233 (Subsequent hospital care, per day ...) range each day the physician sees the patient after the initial day.
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