Inpatient consultation, high complexity

Within Evaluation and Management (E/M) services, CPT code 99255 stands as a representation of subsequent inpatient hospital care with high complexity. This code is reserved for cases where healthcare providers engage in the ongoing management of patients with intricate health conditions, requiring a comprehensive assessment and high-complexity decision-making.

Details

CPT code:

99255

Category:

Category I

Section:

Explore Evaluation and Management CPT Codes

Specialty:

Office or Other Outpatient Consultations

Type:

Inpatient or Observation Consultations

99255 is applied when healthcare professionals oversee patients admitted to the hospital, focusing on cases with high complexity. The code reflects the ongoing efforts to manage patients with intricate health conditions, involving a comprehensive assessment and high-complexity decision-making. Its utilization ensures accurate documentation of the depth and intensity of care provided to patients throughout the course of their hospitalization.

Under what category does Inpatient consultation, high complexity fall?

Category I

What is the billing unit for Inpatient consultation, high complexity?

Per Encounter

Modifiers

-

Clinical use

Initial inpatient consultation for a new or established patient, very high complexity.

Documentation

Initial inpatient consultation; comprehensive history, examination, and high complexity MDM for a high complexity patient.

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