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| billing [2024/01/02 12:25] – created admin | billing [2024/01/03 13:22] (current) – [Inpatient Floor or Consult Billing] admin | ||
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| + | ===== Outline===== | ||
| + | ==== Office or Other Outpatient Services ==== | ||
| + | * Hospital Inpatient and Observation Care Services | ||
| + | * Consultations | ||
| + | * Emergency Department Services | ||
| + | * Nursing Facility Services | ||
| + | * Home or Residence Services | ||
| + | |||
| + | ===== MDM Levels===== | ||
| + | |||
| + | ==== Inpatient Floor or Consult Billing ==== | ||
| + | === Initial Encounter === | ||
| + | ^ Code ^ Requirements, | ||
| + | ^ 99221 | straightforward or low level MDM | if using time, must be >= 40 minutes | ||
| + | ^ 99222 | moderate level MDM | if using time, must be >= 55 minutes | ||
| + | ^ 99223 | High level MDM | if using time, must be >= 75 minutes | ||
| + | |||
| + | === Subsequent Encounter === | ||
| + | ^ Code ^ Requirements, | ||
| + | ^ 99231 | straightforward or low level MDM | if using time, must be >= 25 minutes | ||
| + | ^ 99232 | moderate level MDM | if using time, must be >= 35 minutes | ||
| + | ^ 99233 | High level MDM | if using time, must be >= 50 minutes | ||
| + | |||
| + | ===== Definitions===== | ||
| + | ====New Patient ==== | ||
| + | A new patient is one who has not received any professional services from the physician or other qualified health care professional or another physician or other qualified health care professional | ||
| + | - of the exact same specialty and subspecialty who | ||
| + | - belongs to the same group practice | ||
| + | - within the past three years. | ||
| + | =====Tables ===== | ||
| + | |||
| ^Code Type^ CPET Code^ | ^Code Type^ CPET Code^ | ||
| | Hospital Inpatient and Observation Care Services E/M codes | 99221-99223, | | Hospital Inpatient and Observation Care Services E/M codes | 99221-99223, | ||
| | Consultations E/M codes | 99242-99245, | | Consultations E/M codes | 99242-99245, | ||
billing.1704198343.txt.gz · Last modified: 2024/01/02 12:25 by admin
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