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Oncology & Hematology Coding Alert

You Be the Coder:

Admission Determines Specific Observation Codes

Published on Wed Apr 13, 2005

Question: Another doctor asked my oncologist for a consult with a patient who had been admitted for an observation stay. Should I use 99218-99220?


New Hampshire Subscriber


Answer: Because your oncologist is involved with the patient in a consultative capacity, you should report his services with the appropriate outpatient consultation code (99241-99245).

If your doctor admits the patient to the hospital, however, you should more accurately report his service with the applicable hospital admission code (99221-99223).

Only one physician can bill the observation admit codes (99218-99220, Initial observation care, per day ...) per observation stay. 


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