Wiki Initial vs Subsequent Hospital Care Coding

[kelly.peplinski@risingms.com]

I think I have a provider being thrown off by "per day" in the description of 99221. To verify that my knowledge of the code is accurate - can this code be billed on multiple dates of service? I have always read it as 99221-99223 should be billed once per admission and 99231-99233 would be billed by that physician on subsequent dates. For example, the physician is using 99221 for each date from 3/5-3/10.

 

[shawnab27]

the 99221-99223 is consult codes, they get that the first initial time, any days after that would be subsequent 99231-99233

 

[trarut]

You are correct in how you are interpreting the codes.

The details in the code descriptor for 99221-99223, it clearly references the "...problem(s) requiring admission..." while 99231-99233 has reference to the patient status on that day, in addition to being identified as Initial or Subsequent care. Your provider knows they aren't admitting or consulting on the patient every single day during the hospitalization so it should be an easy fix