Wiki New vs established help

[Jsamansk@gmail.com]

I’m trying to understand the initial hops care vs subsequent hosp...if the initial care is only for the first visit by the admitting doc why is it that it says “per day” for 99221. I am not understanding something about this and can’t seem to find the answer in searching this forum. If this is not the area to post can someone guide me to the correct area? Thanks.

 

[thomas7331]

I’m trying to understand the initial hops care vs subsequent hosp...if the initial care is only for the first visit by the admitting doc why is it that it says “per day” for 99221. I am not understanding something about this and can’t seem to find the answer in searching this forum. If this is not the area to post can someone guide me to the correct area? Thanks.

The hospital care codes say 'per day' because the code represents all E&M services performed on that day by the provider. In a hospital setting where patients are acutely ill, providers may see a patient multiple times but all of the visits by that same provider must be combined into a single code for reporting purposes. A couple of thing to add - while you're correct that this code is for the admitting doctor, for Medicare patient and other payers that do not accept consultation codes, this code will also be used by consulting physicians for their initial visit with the patient in addition to the admitting physician. Also, in a hospital setting there is no 'new' vs. 'established' distinction. The initial visit is the first visit during a particular admission and subsequent care codes are used thereafter during that same hospital stay. New and established code distinctions only apply to the outpatient/office setting. Hope this helps some.