Neurosurgery Coding Alert

Question: The neurosurgeon admits a patient with neck injuries through the emergency department (ED). During the patient's treatment, the neurosurgeon calls in several specialists to assist in the care. Can I report a hospital admission code for his services?

Ohio Subscriber Answer: When the neurosurgeon admits a patient from the ED and assumes full responsibility for the patient's care, you can report an admission code. If the surgeon just manages part of the patient's treatment (for example, that related to the spine, neck, etc.), you cannot use the hospital admit codes.

Suppose the surgeon treats the patient's neck injury and then outlines a care plan for the patient. On the claim, report one of the following codes for the hospital admit, depending on the operative notes:

- 99221 -- Initial hospital care, per day, for the evaluation and management of a patient, which requires these three key components: a detailed or comprehensive history; a detailed or comprehensive examination; and medical decision-making that is straightforward or of low complexity

- 99222 -- - a comprehensive history; a comprehensive examination; and medical decision-making of moderate complexity

- 99223 -- - a comprehensive history; a comprehensive examination; and medical decision-making of high complexity. Remember: Only one physician can charge the hospital admission code per patient. This means that if a pair of physicians co-manage a patient, only one of them can bill for the admission.