Section 20-2-II - GENERAL GUIDELINESThe E/M section is divided into broad categories such as office visits, hospital visits, and consultations. Most of the categories are further divided into two or more subcategories of E/M services. Keep the following in mind when coding each service setting:
A. A patient is considered an outpatient at a health care facility until formal inpatient admission occurs.B. All physicians use codes 99281-99285 for reporting emergency department services, regardless of hospital-based or non-hospital-based status. C. Admission to a hospital or nursing facility includes E/M services provided elsewhere on the same day. D. Not more than one hospital visit per day shall be payable except when documentation describes the medical necessity of more than one visit by a particular practitioner. Hospital visit codes shall be combined into the single code that best describes the service rendered. E. Only one provider is reimbursed for a patient visit, except where wound care evaluation is provided in an established wound care center.