Deleted Hospital Inpatient and Observation Care Service Codes
- 99217: Observation care discharge day management
- 99218 – 99220: Initial observation care for evaluation and management, levels 1 – 3
- 99224 – 99226: Subsequent observation care for evaluation and management, levels 1 – 3
The same codes will now be employed for both observation and inpatient care. The descriptors have been updated to reflect this. For initial services, use 99221 – 99223. For subsequent visits, use 99231 – 99233. For a discharge after multiple days of care, use 99238 – 99239. For a patient who is admitted and discharged on the same calendar day, 99234 – 99236 should be applied.
Deleted Consultation Codes
- 99241: New or established office or other outpatient consultation service
- 99251: New or established initial inpatient consultation service
The two lowest-level consult codes are being deleted, and the levels above can be used instead.
Deleted Nursing Facility Service Code
- 99318: Evaluation and management of a patient involving an annual nursing facility assessment
The service should now be reported with 99307 – 99310, the subsequent nursing facility care service codes.
Deleted Domiciliary, Rest Home, or Custodial Care Services Codes
- 99324 – 99328: New patient domiciliary, rest home, or custodial care services, levels 1 – 5
- 99334 – 99337: Established patient domiciliary, rest home, or custodial care services, levels 1 – 4
- 99339 – 99340: Domiciliary, rest home, or home care plan oversight services, levels 1 – 2
To report services in domiciliary, rest home, or custodial care facilities, use the home or residence services codes. For new patients, apply 99341 – 99342 or 99344 – 99345 codes. Use codes 99347 – 99350 for established patient home or residence services.
Deleted Home or Resident Services Code
- 99343: New patient home services
The other levels of this service, 99341 – 99342 or 99344 – 99345 codes, should take its place.
Deleted Home or Resident Services Code
- 99343: New patient home services
The other levels of this service, 99341 – 99342 or 99344 – 99345 codes, should take its place.
Deleted Prolonged Services Codes
- 99354 – 99357: Prolonged service with direct patient contact, levels 1 – 4
Code 99417 replaces 99354-99355 for prolonged care, but it can only be billed with a level 5 office visit. For Medicare, the code G2212 must be applied instead. The new code 99418 replaces 99356 – 99357.
Emergent Code Descriptor Change
- 99281: This no longer requires the presence of a physician or other qualified health care professional. Care provided by a hospital-employed nurse cannot be billed with 99281.
Selecting a Level of Service in 2023
With these deletions, it is important to review the requirements for selecting a level of care. Time or medical decision-making can still be used, but there are some subtle changes to the requirements. Examples include previously allowed travel time no longer being taken into consideration to select the level or the time intervals shifting by 15 minutes. It is important to keep this in mind.