CPT^® 99221, Under New or Established Patient

The Current Procedural Terminology (CPT^®) code 99221 as maintained by American Medical Association, is a medical procedural code under the range - New or Established Patient.

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Summary

The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical decision making or the provider spends at least 40 minutes of total time on the encounter on a single date.

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CPT codes for inpatient substance abuse MAT treatment, mostly with suboxone and subutex.

Hi Taliafate Ensure document properly, listing medication prescribed given, and dx range from F11 to F14 F16 F17 linking with description of care given. Medicare coverage is lsited as such...there are... [ Read More ]

Insurance Denial

In March 2022 I went to the ER because I thought I had a blood clot in my thigh. I did and I also had a pulmonary embolism. I was kept overnight in Observation and for a second night. I was admitt... [ Read More ]

Initial Hospital Care codes and Admission to Hospital dates?

If you did an inpatient consult, but the carrier does not accept consult codes, the Medicare guideline specify you may use initial inpatient 99221-99223. They also state if you do not meet 99221 (sinc... [ Read More ]

Initial Hospital Care codes and Admission to Hospital dates?

We use the 99221 - 99223 codes when we are NOT the admitting physician. The admitting physician is supposed to be using the ai modifier so that other specialists can get paid. There is an old post a... [ Read More ]

Initial Hospital Care codes and Admission to Hospital dates?

We've had an error pop up on some claims in ECW when we use initial hospital care codes on dates that are not the date of admission to a hospital. Should we be using subsequent hospital care codes or ... [ Read More ]

2022 Split/Shared Visits

Am I correct in thinking that the only codes that are allowed to be billed as a Split (or Shared) are codes 99202-99215 (Other Outpatient) , 99217-99226 (Hospital Observation), 99221-99239 (Hospital I... [ Read More ]

Diagnosis not documented on DOS diagnosis initial encounter inpatient m62.82 n17.9 subsequent care

We are doing profee billing for hospital care services. [LIST] [*]For the initial hospital care (99221-99223) visit documentation states that patient came into the hospital and was found to have an ... [ Read More ]

Is it ok to bill 99152 in an office setting?

[QUOTE="TammyBennett, post: 512579, member: 382600"] I too am billing 99156 and 99157 and getting them denied. I am going to switch to 99152 and 99153 to see if this does pay [/QUOTE] Read the descri... [ Read More ]

GIP and IP billing

Hello, I'm new to the coding and billing world of Palliative Care. My question is how do I bill two initial consult codes (99221,99222 or 99223) if my provider saw the patient for an initial consult t... [ Read More ]

Inpatient E & M

[QUOTE="csperoni, post: 510908, member: 164618"] Actually, if you did a consult, but the carrier does not accept consult codes, the Medicare guideline state you may use initial inpatient 99221-99223. ... [ Read More ]

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