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Inpatient Facility Coding & Compliance Alert

Monitoring Status Marks Whether Observation with Infusion Is OK

Published on Sat Jun 30, 2012

Coding for hospital observation services comes with some unique challenges, especially when the patient receives therapeutic infusions, hydration services, or other types of drug administration. Keep the following points in mind when deciding whether you can charge for these services during observation care.
Starting point: You should not bill "observation" services concurrently with diagnostic or therapeutic services when active monitoring is part of the procedure, according to the Medicare Claims Processing Manual (Chapter 4 Section 290.2.2).One common example would be chemotherapy.
Remember Interruptions Can Change Reporting

If, for some reason, the infusion/drug administration service interrupts the observation service and leads to two or more distinct observation periods, you can report all services. Record the beginning and ending times of each observation period, then add the lengths of time for all the observation periods. That total time will help you determine the total number of [...]
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