tci Part B Insider - 2010 Issue 3

PART B MYTHBUSTER: CPT Doesn't Include 'Admit' Codes

Codes 99221-99223 refer to inpatient care. Myth: If your physician admits a patient to the hospital, you are justified in reporting an "admit code." Reality: CPT does not include a code for hospital admission itself. The admitting physician should report codes 99221-99223 for his care if he documents the elements contained within the codes (appropriate history, exam and medical decision-making). He is not billing for the admit itself - he's billing for the care that he provides, based on the documentation. "CPT clearly states that the initial hospital care codes should be used to report the 'first hospital...

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