Hi David
This is not a simple answer. Depends on if you are primary attending or consulting MFM. If you are doing a delivery or antepartum care or PP care or both or all 3.
In general, there are a number of inpatient codes that can be used - here are some very brief/general descriptors
Initial hospital care – E&M codes (99221, 99222, 99223) used to report the first hospital inpatient encounter between the patient and admitting physician.
Subsequent inpatient care – E&M codes (99231, 99232, 99233) used to report subsequent hospital visits.
Hospital Discharge Day Management Services – E&M codes (99238, 99239) used to report the work performed to discharge a patient from an inpatient stay.
Admission and Discharge Same Day – E&M codes (99234 – 99236) used to report services for a patient who is admitted and discharged from an observation or inpatient stay on the same calendar date. Patient's stay must be a minimum of eight hours in order to bill these codes.
There are modifiers to attach as well, again depending on what was done that day.
I would suggest the chapter on inpatient coding in our Coding Manual available in the bookstore:
https://www.smfm.org/product/2-smfm-2021-coding-manualor searching on the smfm website under coding Q&A, category 'E/M- inpatient'. We have over the years answered > 30 questions regarding inpatient billing, and you might find more specific advice there.
Best,
Vanita
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Vanita Jain, MD
Chair, SMFM Coding Committee
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Original Message:
Sent: 06-11-2021 14:51
From: David PRINCIPE
Subject: Billing Hospital
When billing for doing hospital rounds .. what is the appropriate CPT code to use .. and is there a modifier that should be used ?
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David PRINCIPE
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