Which CPT code range is used for the initial hospital care evaluation and management on hospital admission?

Which CPT code range is used for the initial hospital care evaluation and management on hospital admission?

• A. 99221-99223
• B. 99202-99205
• C. 99391-99397
• D. 99241-99245

Answer: (A)

The key idea is that the first evaluation and management service for a patient admitted to the hospital is billed with initial hospital care codes. The range 99221-99223 is used for that initial hospital day, with the level chosen based on the complexity of the history, examination, and medical decision making. In practice, these codes cover the physician’s first inpatient assessment on admission. If care continues on subsequent hospital days, different codes apply (99231-99233) for subsequent inpatient care. The other ranges correspond to different contexts: 99202-99205 are outpatient office visits for new patients; 99391-99397 are periodic preventive medicine exams for established patients; 99241-99245 are hospital or outpatient consultations rather than the initial admission evaluation.

The key idea is that the first evaluation and management service for a patient admitted to the hospital is billed with initial hospital care codes. The range 99221-99223 is used for that initial hospital day, with the level chosen based on the complexity of the history, examination, and medical decision making. In practice, these codes cover the physician’s first inpatient assessment on admission.

If care continues on subsequent hospital days, different codes apply (99231-99233) for subsequent inpatient care.

The other ranges correspond to different contexts: 99202-99205 are outpatient office visits for new patients; 99391-99397 are periodic preventive medicine exams for established patients; 99241-99245 are hospital or outpatient consultations rather than the initial admission evaluation.