tci General Surgery Coding Alert - 2010 Issue 7

Reader Questions: Straighten Out Your Modifiers For ER Admit

Question: Our doctor saw a patient in the emergency room and decided to admit him and perform surgery. This patient is not Medicare. Do I code this using 99221-99223, as an outpatient E/M code, or with an emergency room E/M code? Also do I need to add a modifier if our doctor is the admitting physician?Missouri SubscriberAnswer: You should use 99221-99223 (Initial hospital care ...), assuming that your surgeon's documentation will support the code. Once the patient is in inpatient status (per the hospital), you can no longer use outpatient codes.Since this is not a Medicare patient...

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