CPT COdes E/M same/diff Day

For quick reference and this is also in your CPT book on page 23 (initial hospital inpatient or observation care services):

Same Day Stay (less than 8 hours)

• Use codes: 99221-99223

• When to report: If the patient is admitted and discharged on the same calendar date, but the total stay is less than 8 hours.

• Do not use: Discharge codes (99238, 99239) are not reported in this case.

Same Day Admission and Discharge (minimum 8 hours)

• Use codes: 99234-99236 ( code description says "including admission and discharge on the same date" - highlight it)

• When to report: If the patient is admitted and discharged on the same calendar date and the stay lasts at least 8 hours.

• Important: These codes require two separate face-to-face visits - one for the addmission and one for the discharge-both performed by the same provider.

• Do not use: Discharge codes (99238, 99239) are not reported in this case. 

Admission and Discharge on Different Dates

• Use codes:

  • Admission (day 1): 99221-99223

  • Discharge (final day): 99238 or 99239, depending on time spent on discharge

• When to report: Initial date is different than discharge date BUT the length of stay is 8 hours or more.

                  OR

• Use Codes: 99221-99223

• When to report: Initial date is different than discharge date BUT the length of stay is less than 8 hours.

***I wouldn’t be too concerned about disputes over time—your exercises and quiz questions are designed to be clear and won’t leave you second-guessing the length of stay. 

***Imagine yourself going to the hospital and leaving 2 hours later vs 10 hours later vs going in on Friday 8pm and leaving on Saturday 8am. Which codes would you use?