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Thread: E/M Code regarding initial hospital care

  1. #1
    Join Date
    Apr 2007
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    33

    Default E/M Code regarding initial hospital care

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    Hello
    i have quick question , if Dr document time 20 min in critical care unit and if i want to use E/M code can i use 99221 (even though it say 30 min spend in bed side). i appreciate for your help. thanks

  2. #2
    Join Date
    Apr 2007
    Location
    Seattle First Hill
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    126

    Default

    It doesn't sound like it. In order to bill a 99221, all 3 components must be met- detailed or comprehensive history, exam, & MDM that is straightforward or of low complexity. The times listed are averages.

    To bill based on time, it must be documented that greater than 50% of the visit was spent in counseling &/or coordination of care.

    Hope this helps,
    Kirsten, CPC

  3. #3
    Join Date
    Apr 2007
    Posts
    33

    Smile

    Kirsten,
    Thank you so much for responding i will try to see if medicare web site if any code correspond to this situation. thanks again.

  4. #4
    Join Date
    Apr 2007
    Location
    Seattle First Hill
    Posts
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    Default

    I think I may have misunderstood your question.

    Yes, you can bill a 99221 IF the documentation supports that code. The times listed in CPT are averages and the code should not be based on that alone UNLESS the doctor has a statement that he spent XX amount of minutes and over 50% of that was spent in counseling and/or coordination of care. Hope that makes sense!

    ~Kirsten, CPC

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