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Gastroenterology Coding Alert

Reader Question:

Initial Observation Codes Are for the Admitting Doctor Only

Published on Wed Dec 03, 2003

Question: If one of our doctors is called in to consult on a patient who was admitted to observation by another doctor, are there any circumstances under which we can report the consultation using the initial observation care codes?

West Virginia Subscriber

Answer: Not if your doctor isn't the one who admitted the patient to observation. Select the appropriate-level consultation code (99241-99245).

Keep in mind that only the admitting physician can get reimbursed using initial observation codes. Any E/M services given by another physician must be billed using the consultation codes (99241-99245).

- Clinical and coding expertise for You Be the Coder and Reader Questions provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the CPT advisory panel; and Linda Parks, MA, CPC, CCP, coding and billing coordinator for GI Diagnostic Endoscopy Center in Atlanta.

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