Please refer to the November, 2017 INITIAL HOSPITAL CARE VISIT BULLETIN. The MO HealthNet Division (MHD) limits payment for Current Procedural Terminology (CPT) codes 99221, 99222, and 99223, to one (1) per inpatient stay. These codes are to be used to report the first hospital initial inpatient encounter by the admitting physician, according to The CPT Professional Codebook.
Multiple physicians cannot bill the initial inpatient visit. The CPT book says only the admitting physician can bill the initial hospital care code. These codes are not to be billed when providing a consultation; only initial hospital admission visit.
Providers should use a consultation, daily visit, or discharge code that accompanying documentation supports when submitting a paper claim.
Claims should report actual admission and discharge dates, not the date of the consultation or hospital visit.