Results 1 to 6 of 6

Initial Hospital Care

  1. #1
    Default Initial Hospital Care
    Medical Coding Books
    Any suggestions or thoughts on the correct code for an initial hospital encounter with an EPF history, EPF exam and MDM of high complexity?
    99221, the lowest level of initial hospital care requires a detailed history, detailed exam and MDM if low complexity.

    Jenny Berkshire, CPC-GI, E/M

  2. #2
    How much time was utilized??

  3. #3
    Time was not documented. I read some previous posts that suggest the subsequent hospital visit codes (99231-99233) be used.

  4. Default
    yes, this is still a gray area for me too. i cant find any definitive documentation on this. some people state to use an unlisted code while others downcode to a subsequent visit.

    i'm curious too!!

  5. Default Initial Hospital Care
    Hi j.berkshire,

    I am looking in the AMA CPT 2008 E/M Pocket Reference Guide and found this paragraph:

    "A critical guideline of this code series indicates that codes 99221-99223 are reported for the first hospital inpatient encounter with the patient by the admitting physician. This date may not be the same as the date the patient was admitted to the hospital"

    I would think that code 99223 for what you described.

    Just my $.02 worth.

    Pedenia Y. Evans, CPC

  6. Default
    Was this patient seen at another site before being admitted to the hospital, such as the physician's office? If so, that service could be included in determining your inpatient hospital care code. If not, I believe you would only be able to charge the lowest level.

Similar Threads

  1. Replies: 3
    Last Post: 07-09-2015, 06:40 AM
  2. Replies: 6
    Last Post: 07-02-2013, 08:37 AM
  3. Replies: 3
    Last Post: 09-26-2012, 08:21 AM
  4. Replies: 2
    Last Post: 01-21-2009, 06:39 PM
  5. Initial hospital care
    By stgregor in forum E/M
    Replies: 3
    Last Post: 08-22-2008, 06:06 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.