cpt 99238, cpt code 99238, 99238 cpt code

CPT Code 99238 | Description, Procedure & Billing Guidelines (2022)

CPT 99238 may be billed for services provided to patients on the hospital discharge day. The total time spent on this service should be at most 30 minutes. 

1. What Is CPT Code 99238?

CPT 99238 covers services provided to a patient when discharged from a hospital. A health provider spends 30 minutes or less with the patient. This can be done directly or indirectly.

2. Description

The CPT book describes the CPT code 99238 as follows: “Hospital discharge day management; 30 minutes or less.”

3. Procedure

The 99238 CPT code procedure can only be provided when a patient is discharged from the hospital. A provider spends a maximum of 30 minutes with the patient on the discharge day and spends time on services like;

  • referral forms;
  • prescriptions;
  • preparation of final discharge records;
  • coordination and instruction for ongoing care with caregiving agencies;
  • final examination; and
  • discussion and review of the hospital stay.

4. Billing Guidelines

The 99238 CPT code procedure does not need to be performed directly with the patient discharged from the hospital.

The time spent on the procedure does not have to be continuous.

Do not use CPT code 99238 if the patient is admitted and discharged on the same day. Instead, you can report E/M services CPT 99234, CPT 99235, and CPT 99236.

Only bill CPT 99238 if the total time spent on this procedure is 30 minutes or less. If more than 30 minutes are spent, report CPT code 99239 instead.

5. Resources

CPT Professional 2022

https://www.aapc.com/codes/coding-newsletters/my-otolaryngology-coding-alert/reader-questions-understand-face-to-face-visit-rules-170972-article

https://www.ama-assn.org/system/files/telehealth-services-covered-by-medicare-and-included-in-cpt-code-set.pdf

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