Initial Hosp Service vs. Subsequent hospital visits

Please help. What are some options when coding for an Initial Hosp Sevice (99221-99223), patient admitted from the ED, when my E/M codes are History-Comprehensive, Exam-Exp Prob Focused, and MDM-Moderate. Is it okay to use the Subsequent Hospital Care codes instead? Thank you

re: Initial Hosp Service vs. Subsequent hospital visits

if this is a Medicare patient and your physician did the admit from er then 99221-23 -AI. (admitting initial) if your physician is not the adminiting then 99221-23 with out modifier. subsequent codes should only be used on 2nd or more visits

re: Initial Hosp Service vs. Subsequent hospital visits

Okay, the Exam level was Exp Prob Focused and in order to choose 99221 it has to be Hx-D/C, Exam-D/C, MDC-Straightforward/Low to High Complexity. So i shouldn't bill? Patient is Non-MCR. Thanks

re: Initial Hosp Service vs. Subsequent hospital visits

Okay, the Exam level was Exp Prob Focused and in order to choose 99221 it has to be Hx-D/C, Exam-D/C, MDC-Straightforward/Low to High Complexity. So i shouldn't bill? Patient is Non-MCR. Thanks

[if this is a Medicare patient and your physician did the admit from er then 99221-23 -AI. (admitting initial) if your physician is not the adminiting then 99221-23 with out modifier. subsequent codes should only be used on 2nd or more visits]

re: Initial Hosp Service vs. Subsequent hospital visits

In the inpatient hospital setting and the nursing facility setting, physicians (and qualified nonphysician practitioners where permitted) may bill the most appropriate initial hospital care code (99221-99223), subsequent hospital care code (99231 and 99232), initial nursing facility care code (99304-99306), or subsequent nursing facility care code (99307-99310) that reflects the services the physician or practitioner furnished. Subsequent hospital care codes could potentially meet the component work and medical necessity requirements to be reported for an E/M service that could be described by CPT® consultation code 99251 or 99252.
Contractors shall not find fault in cases where the medical record appropriately demonstrates that the work and medical necessity requirements are met for reporting a subsequent hospital care code (under the level selected), even though the reported code is for the provider's first E/M service to the inpatient during the hospital stay. Unlisted evaluation and management service (code 99499) shall only be reported for consultation services when an E/M service that could be described by codes 99251 or 99252 is furnished, and there is no other specific E/M code payable by Medicare that describes that service.
http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R2282CP.pdf