99221-3

[Bigasammie]

Hello out there.
I am in the midst of a discussion with some of my hospitalists.
They want to know why they cannot use a code from the 99231-3 catagory if they are unable to obtain a detailed HPI for the 99221-3 catagory.
Do I remember reading somewhere that it was ok to change to a 99231-3 if the documentation did not support the 99221-3? My instincts tell me that this is not appropriate since it is the initial visit.
Thank you.

[Jagadish]

If they can document why history taking was not possible, we can consider HPI as extended and can bill 99221-23.

[Bigasammie]

Even if the reason is that the patient does not speak English?

[Jagadish]

We can apply this only when the pateint is unconscious, intubated or in AMS. In that case i would suggest 99499 to 99231-233.

[valleycoder]

i agree. i dont think language barriers are justifiable reasons for not obtaining HPI....but still billing the admit codes. there are ways to work around that obstacle including utilizing language lines. Guidelines state to use 99499 if all criteria isnt met but i have been known to use the subs visit codes sometimes.
HTH