Oncology & Hematology Coding Alert

Count the hours for single-day stays, or beware the consequences. Physicians are admitting more patients than ever to observation status -- so government auditors will be scrutinizing these claims like never before. Medicare restrictions have made many hospitals tighten the criteria for what constitutes an inpatient stay.Result: Some patients linger in observation care for longer than the average period -- in some cases up to two weeks, according to a Dec. 11, 2008, notice from the Center for Medicare Advocacy. As hospital policymakers set standards regarding which patients qualify for observation care and which should be inpatients, you as a physician coder need to ensure that your observation coding practices are pristine. Include Same-Day Office Visit in Observation If your oncologist sees a patient in his office for dehydration, for example, and decides to subsequently admit that patient to observation status, you should not report both the office E/M (such as 99212, [...]