LeahJ123
New
Hi everyone,
I am not understanding this scenario:
Patient is located in an acute care hospital, but is on observation status for three days then discharged. The physician was brought in on a consult, and is billing POS 22, 99252 for day 1, and for day 2 is billing POS 21 and 99232.
I thought the physician should bill for day 1 POS 22 and 99218-99220 and for day 2 bill POS 22 and 99211-99215.
A coworker is telling me that it should be paid as billed under "law of agency rules", meeting medical necessity.
I am not understanding why if the patient is in observation status, the physician is not billing observation codes then office code for day two since the patient is not technically "inpatient" in the acute care facility.
Can someone explain this to me please?
Thanks for your help!
Leah Johnson RN
I am not understanding this scenario:
Patient is located in an acute care hospital, but is on observation status for three days then discharged. The physician was brought in on a consult, and is billing POS 22, 99252 for day 1, and for day 2 is billing POS 21 and 99232.
I thought the physician should bill for day 1 POS 22 and 99218-99220 and for day 2 bill POS 22 and 99211-99215.
A coworker is telling me that it should be paid as billed under "law of agency rules", meeting medical necessity.
I am not understanding why if the patient is in observation status, the physician is not billing observation codes then office code for day two since the patient is not technically "inpatient" in the acute care facility.
Can someone explain this to me please?
Thanks for your help!
Leah Johnson RN