Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

Initial and Subsequent Hospital Inpatient codes

Lynne Posted Thu 25th of October, 2012 14:55:25 PM

Do you have to have an Intial Hospital care code from range (99221-99223) to bill a Subsequent Hospital Care code for the first inpatient encounter by the admitting physician?

The patient was admitted into the hospital on 10/09/12 and the initial visit was coded as (99232) a subsequent code on the admit date. When asked about this she stated there was not enough documentation to bill an initial visit. So we asked what guideline this decision is derived from and the coder quoted from CMS.

But when reading this page it reffered to the consultation payments.

SuperCoder Answered Fri 26th of October, 2012 15:58:49 PM

The subsequent hospital care (99232) cannot be coded for the initial visit on the admit date. If documentation supports to code atleast the lowest level of initial hospital care (99221), you can code 99221. If enough documentation is not there to meet the criteria for 99221, the chart cannot be coded.

You can request your physician to send complete documentation to code it.

Related Topics