Wiki 60 minute inpatient consult CPT code?

[dee10535]

Working on a problem in a medical coding book. Consultant spent 60 minutes total time on an inpatient consult for a patient. Code was reported as 99253. Why wouldn't we use 99254 since the time criterion of 60 minutes is met for the higher level service?

 

[cjhalk@yahoo.com]

Can you post the full question? Just based on this, I do not see where the 99253 would be correct. CPT Assistant March 2023, "
All the codes in code series 99252-99255 were revised to include observation consultation services in addition to inpatient hospital care. The code descriptor revisions follow the same coding structure implemented with the E/M changes in 2021, which removed patient medical history and physical examination as key components for code selection. Instead, either MDM level or time threshold on the date of the encounter may be used to select the appropriate level of code. The time thresholds were changed in the descriptors as shown in Table 2, which summarizes the time revisions for 2023. Also, the new add-on prolonged services code 99418 was established to report prolonged inpatient or observation consultation services. Code 99418 may be reported in 15-minute increments, which begins 15 minutes beyond the highest-level code (99255) threshold (ie, >95 minutes) for the inpatient or observation consultation when time is used as the basis of code selection.



Table 2. Inpatient or Observation Consultation Time Revisions in 2023

Codes	Time Threshold (min) in 2023
99252	35
99253	45
99254	60
99255	80
99418 (Prolonged)	95