Q&A E/M Level coding for the physician only not the facility

[Linda Charlwood]

Hi!

So if you are coding for the physician services only in the ED setting and the physician is NOT an employee of the hospital - he is independant of the hospital, and the patient is admitted to the hospital do you code the level charge from 99221-99223 or 99281-99285 for the physician services?

Thanks!
Linda

 

[Donna]

Hi!

So if you are coding for the physician services only in the ED setting and the physician is NOT an employee of the hospital - he is independant of the hospital, and the patient is admitted to the hospital do you code the level charge from 99221-99223 or 99281-99285 for the physician services?

Thanks!
Linda

You would use 99281-99285 codes as 99221-99223 are initial hospital care codes. 99281-99285 are specifically for the ED setting and they are not used beyond that.

 

[Ruth Sheets]

Laureen answered the original question in this thread in the December 2013 Q&A Webinar. The guidelines tell us ONLY the admitting physician can use the initial hospital care codes. So it doesn't matter if they are independent or not: it matters if they are the admitting physician of record. If not, then they are to use subsequent hospital care codes.

If you missed the webinar, you can join the CCO Club, and get access to webinar transcripts and Answer Sheets, and for months where they are available (since May 2013), you can also get access to a webinar CEU quiz.