Coding for a Hospital Visit

Coding for a Hospital Visit

June 2, 2022

I was at your conference this past weekend and I was wondering if you could clarify something for me. When a physician sees a Medicare patient in the hospital, and it is their first time seeing the patient however they are NOT the admitting physician, they can only bill a subsequent visit or consult code depending on what the payor allows and documentation correct? Thank you for your assistance.

If the physician is seeing the patient in the hospital for the first time even though he/she is not the admitting physician based on appropriate documentation, an initial hospital visit code (99221-99223) can be billed as long as all three key component requirements are met.  If the minimum requirement for the initial hospital care code is not met a subsequent hospital visit can be reported.  Keep in mind Medicare does not pay for consultations.

*This response is based on the best information available as of 06/02/22.







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