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CPT Code 99223 | E/M Services For Initial Hospital Care

Report CPT 99223 for initial hospital care for evaluating and managing a patient and requires three key components.

What Is CPT Code 99223?

CPT code 99223 is used to report the evaluation and management of a patient in the inpatient hospital setting.

This code reports a hospital visit that requires a significant amount of time and resources and includes a comprehensive evaluation and management of the patient’s medical condition.

The CPT code 99223 is used to report a hospital visit that involves a detailed history and physical examination, as well as developing and implementing a treatment plan for the patient.

It may also include ordering and interpreting diagnostic tests, consulting other healthcare providers, and providing patient education.

Description

The CPT book describes CPT code 99223 as: “Initial hospital care, per day, for the evaluation and management of a patient, which requires these three key components:

  • A comprehensive history;
  •  A comprehensive examination; and
  •  Medical decision-making of high complexity.

Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs.

Usually, the problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient’s hospital floor or unit.”

Procedure

Initial hospital care is reported for a patient admitted to the hospital as an inpatient. The level of service is decided based on the three key components of history, examination, and medical decision-making.

For reporting 99223, the admitting physician should perform a comprehensive history; a comprehensive examination and the medical decision-making should be of high complexity.

The physician spends about 70 minutes, including face–to–face time with the patient and time spent in the coordination of care.

  1. Resources

CPT Professional 2022

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