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Admit to Observation and Procedure same day and Discharge from Observation Next Day

Phejes

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Messages
1
Best answers
0
I have a Cardiologist that did a Pre-Op H and P 8 days before procedure. His colleague in same group admitted the patient to Obeservation and performed the Pacemaker lead and battery replacement. On the following day the patient was discharged from observation. Is this correct coding?
Example: 3/1/2013 99213 Pre-Op Dr. A
3/7/2013 99219 by Dr. B
3/7/2013 33208 by Dr. B
3/8/2013 99217 By Dr. B

Could someone please clarify for me.

Thank You
 

jimbo1231

Expert
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370
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0
Looks Right

The Observation codes look correct based on admission to Obs on day 1 and discharge on day2. Since there was a procedure along with an E&M, you might need a modifier, 25, on the first day of Obs. And of course the Obs. admission/plan etc documentation has to be there along with documentation that would support the level of Obs. coded.

Jim
 

Salemcoder

Networker
Messages
35
Location
Salem Oregon
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0
Admit to Obs & Procedure same Day

I am thinking that you would not be able to bill for the 99219 if you bill under a group NPI, since it is the same day as the procedure, and the H&P was already performed. Also, I would not bill the discharge, it would be included in the global package I believe. I'm interested in other thoughts......
 

agood

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4
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Lima Local Chapter
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I agree that you can NOT bill the E/M with the 25 modifier. You have already made the decision to do the surgery. The day the patient went into observation was not the day the decision was made. Unless the patient had an unforeseen, unlrelated issue bring them to the hospital you should not be billing an E/M on a planned surgery.
 
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