tci Medicare Compliance & Reimbursement - 2019 Issue 2

Targeted Probe And Educate: Watch Your Subsequent Care Coding, Medical Reviews Suggest

Hint: Incorrect coding tops the denial reasons for these codes. Billing subsequent hospital care visits may seem simple at first glance. But, recent CMS data indicates that for Medicare providers, it may be more complex than you think. Context: Some of the Medicare Administrative Contractors (MACs) have listed CPT® codes 99232 (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity … 25 minutes are spent at the bedside...

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