Question Are outpatient codes (99212-99215)appropriate?

jenpudua32

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Apple VAlley, CA
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When an insurance, for example, Medicaid, doesn't pay for observation services we would normally bill an equivalent ER code (99281-99285) for the initial visit since the patient is normally seen in the ED. If the patient is seen or discharged from observation on another date, would it be appropriate to bill an outpatient visit? 99212-99215 with POS 22?
 

amyjph

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Munising, MI
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If the payer doesn't allow observation codes that would be the only option - it's office or other outpatient. There's nothing else it could be since they are admitted as observation, no longer ED codes, and you wouldn't be able to use 9922_. Unless the payer designates in guidelines some other way they want it.
 

jenpudua32

Contributor
Messages
12
Location
Apple VAlley, CA
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If the payer doesn't allow observation codes that would be the only option - it's office or other outpatient. There's nothing else it could be since they are admitted as observation, no longer ED codes, and you wouldn't be able to use 9922_. Unless the payer designates in guidelines some other way they want it.
Thank you for confirming!
 
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