tci E/M Coding Alert - 2017 Issue 5

You Be the Coder: Receive Guidance on 99221 and 99238

Question: Can you bill 99221 and 99238 on the same day under any circumstances? For example, the admitting physician saw the patient in the morning (99221). Then, later that night, the admitting physician returned to discharge the patient (99238). Are there any modifiers you can use? California Subscriber Answer: No. According to the April 1, 2017 Correct Coding Initiative (CCI) Edits, you cannot bill 99221 (Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: a detailed or comprehensive history; a detailed or comprehensive examination; and medical decision making that...

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