Wiki E/M Code regarding initial hospital care

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megha

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Hello
i have quick question , if Dr document time 20 min in critical care unit and if i want to use E/M code can i use 99221 (even though it say 30 min spend in bed side). i appreciate for your help. thanks:)
 
It doesn't sound like it. In order to bill a 99221, all 3 components must be met- detailed or comprehensive history, exam, & MDM that is straightforward or of low complexity. The times listed are averages.

To bill based on time, it must be documented that greater than 50% of the visit was spent in counseling &/or coordination of care.

Hope this helps,
Kirsten, CPC
 
Kirsten,
Thank you so much for responding i will try to see if medicare web site if any code correspond to this situation. thanks again.;)
 
I think I may have misunderstood your question.

Yes, you can bill a 99221 IF the documentation supports that code. The times listed in CPT are averages and the code should not be based on that alone UNLESS the doctor has a statement that he spent XX amount of minutes and over 50% of that was spent in counseling and/or coordination of care. Hope that makes sense!

~Kirsten, CPC
 
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