Prior Auth Required

99231 - Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceSubsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded. Code NAME/DESCRIPTION COMMENTS 99231 Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.