tci Medicare Compliance & Reimbursement - 2019 Issue 2

E/M Coding: Master Subsequent Care Coding with 3 Expert Tips

Hint: Avoid consultation codes for Medicare. If subsequent hospital care coding has you stumped, you are not alone. These common inpatient E/M service codes perennially bump up the improper payment rate on the Comprehensive Error Rate Testing (CERT) report and continue to be a hot topic for the Medicare Administrative Contractors (MACs) Targeted Probe and Educate (TPE) program. Keep your claims clean with this advice on how to properly code subsequent care. Here’s an overview of the E/M codes causing all the trouble: 99231 (Subsequent hospital care, per day, for the evaluation and management of a patient, which...

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