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  1. #1
    Question question
    Medical Coding Books
    I have a doctor that saw a patient in the ER he charged an ER consult level III a 99283-25 then he did a 21501 incision and drainage. Then they found a mass and had to admit the patient. The patient stayed in the hospital for 4 days. He is asking if he can charge for the admission and discharge along with the ER consult. I am not sure at all. I code for an ASC not hospital coding.

    Jenny, CPC

  2. #2
    Milwaukee WI
    Default Would need to see the notes
    The scenario, as described seems odd to me. I would need to see all the notes before giving an opinion as to what the correct coding would be. Not at all sure your codes are correct.

    Still, here are two thoughts:
    CPT guidelines tell us (2011 Professional edition, pg 14 in the AMA published book) clearly states:
    When the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service (e.g. hospital emergency department ....) all evaluation and management services provided by that physcian in conjunction with that admission are considered part of the initial hospital care ... (emphasis added by FTB)

    CPT 21501 has a 90-day global ... so you need a -57 modifier (decision for surgery), and NO you can not bill a discharge in any case.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Thanks for your help. I am waiting on the op note still. I was reading page 14 and what I read is he should bill the 99221-99223 codes. It states per day. So does this mean he can charge the code 99221-99223 which ever is appropriate each day this patient is in the hospital. I hope this makes sense.


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