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Fam Pract Manag. 2001 Oct;8(9):19.

An answer provided in the June 2001 Coding & Documentation article [page 21] stated that a physician should submit an initial hospital care code (99221–99223) rather than an office or outpatient visit code (99201–99215) when he or she sees a patient in the clinic and admits him or her to the hospital on the same day. It also stated that for services provided to the patient in the hospital on the following day, the physician should submit the appropriate subsequent hospital care code (99231–99233).

This would be accurate if the physician went to the hospital to do the admission or otherwise saw the patient in the hospital on the date of admission. However, this wouldn’t be accurate if the physician admitted the patient from the office but didn’t see the patient in the hospital until the day after admission. In that case, the services on the date of admission should be coded using an office visit code, and the visit the day after admission should be coded using an initial hospital care code, since, per CPT, it represents “the first hospital inpatient encounter with the patient by the admitting physician.”


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