NOV 30, 2022
Lengthy Inpatient Consultation
I am a pediatric ophthalmologist. While on call at our local hospital, I provided a lengthy inpatient consultation for a Medicare adult with preseptal cellulitis. After discharge from the hospital, the patient will follow up with the comprehensive ophthalmologist. What is the best code to bill?
Effective Jan. 1, 2010, physicians must code hospital inpatient CPT codes 99221–99223 when submitting to Medicare Part B. Some commercial carriers still accept consultation codes.
Through Dec. 31, 2022, inpatient evaluation and management codes still follow 1997 E/M guidelines and use history, examination elements, and medical decision-making (MDM) for final code selection. Time is factored when counseling and/or coordination of care dominates the service. The1997 E/M guidelines for these codes are 30 minutes for 99221, 50 minutes for 99222 and 70 minutes spent at the bedside on the patient’s hospital floor for 99223.
Effective Jan. 1, 2023, all service locations should utilize the revised E/M documentation guidelines. Visit aao.org/em