CPT Knowledgebase - Jun 30, 2023
A patient is admitted to cardiology service as an inpatient. The admitting cardiologist sees the patient and completes a history and physical on day one of the inpatient admission. Based on the cardiologist’s initial evaluation, it is determined that the patient requires a pulmonology consult for evaluation of wheezing. The pulmonologist sees the patient on day two of hospitalization. The consultation is complex in nature and meets the high level of medical decision making (MDM) criteria. Does the pulmonologist report CPT code 99223 (Inpatient hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and a high level of medical decision making) or 99233 (Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and a high level of medical decision making) with modifier 26 (Professional Component) appended to it?To view the Official AMA answer and 1000s more like this:
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