Trendale
Guest
Hello,
Can someone explain to me when it is appropriate to use the initial hospital care codes (99221-99223) and also the hospital Discharge codes (99238-99239)? I just started coding for a PCP, I have never done E/M coding for a primary care physcian before, so as I am reading the documentation for this particular physcian, it led me to believe I should be using the codes I just mentioned above. Please read the following scenarios and tell me what you think:
1.
A patient presented to the physcian's office with SOB. Was then transferred to the emergency room for acute MI. Patient was admitted to the ICU due to having increased troponin of 3.06. The admitting physcian is the PCP that originally seen the patient in the office.
The PCP gave me the H&P to code this scenario, I believe I should be using codes from 99221-99233. The guidelines in the CPT book reads, it is reported for the FIRST hospital inpatient encounter with the patient by the admitting physcian. ( Does this mean the physcian's initial encounter with the patient has to be in the hospital?), but then it goes on to say, when the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service, for example, PHYSCIAN'S OFFICE, all E/M services provided by that physcian in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission.( So after reading this, I believed these were the appropriate codes to use) It also states any other services provided from other sites related to the admission, shoud be included.( does this mean the PCP should not charge an E/M office visit for the same day she is admitting the patient?)
Scenario 2:
Patient presented to the ER with increasing SOB. The patient was found to have bilateral pleural effusion and is being admitted to the hospital for further evaluation and treatment. The PCP gave me the H&P to code this scenario.
The PCP is the admiting physcian, I believe I should be using the initial hospital care codes ( 99221-99233) as well, as the PCP is the admitting physcian. Also two days later she discharged the patient, the documentation the PCP gave me to code for this is very minimal, as it states patient feels better, vital signs are documented, labs, impression and plan. Is this information sufficient and should I use hospital discharge service codes 99238-99239. The other description of the codes I read was if the patient was discharged on the same date.
I appreciate your assistance with both these scenarios and if you have any supporting links, that will be greatful as well. Thanks!
Can someone explain to me when it is appropriate to use the initial hospital care codes (99221-99223) and also the hospital Discharge codes (99238-99239)? I just started coding for a PCP, I have never done E/M coding for a primary care physcian before, so as I am reading the documentation for this particular physcian, it led me to believe I should be using the codes I just mentioned above. Please read the following scenarios and tell me what you think:
1.
A patient presented to the physcian's office with SOB. Was then transferred to the emergency room for acute MI. Patient was admitted to the ICU due to having increased troponin of 3.06. The admitting physcian is the PCP that originally seen the patient in the office.
The PCP gave me the H&P to code this scenario, I believe I should be using codes from 99221-99233. The guidelines in the CPT book reads, it is reported for the FIRST hospital inpatient encounter with the patient by the admitting physcian. ( Does this mean the physcian's initial encounter with the patient has to be in the hospital?), but then it goes on to say, when the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service, for example, PHYSCIAN'S OFFICE, all E/M services provided by that physcian in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission.( So after reading this, I believed these were the appropriate codes to use) It also states any other services provided from other sites related to the admission, shoud be included.( does this mean the PCP should not charge an E/M office visit for the same day she is admitting the patient?)
Scenario 2:
Patient presented to the ER with increasing SOB. The patient was found to have bilateral pleural effusion and is being admitted to the hospital for further evaluation and treatment. The PCP gave me the H&P to code this scenario.
The PCP is the admiting physcian, I believe I should be using the initial hospital care codes ( 99221-99233) as well, as the PCP is the admitting physcian. Also two days later she discharged the patient, the documentation the PCP gave me to code for this is very minimal, as it states patient feels better, vital signs are documented, labs, impression and plan. Is this information sufficient and should I use hospital discharge service codes 99238-99239. The other description of the codes I read was if the patient was discharged on the same date.
I appreciate your assistance with both these scenarios and if you have any supporting links, that will be greatful as well. Thanks!