Billing for Observation (PCP office)

jhendrix08

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Hi everyone....

Question for anyone that can offer some help. We had a new patient yesterday that needed observation after her appt with our physician. She was in our office for about 45min after the appt and the medical assistant checked her blood pressure every 15-20min. The physician is asking if this is something we can bill for but most of the observation codes I see are not used in our type of setting (internal med/pcp). If there is an observation code I can use, would it end up being bundled with the new patient cpt code?

I appreciate any feedback. Thanks!
 

thomas7331

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There are codes 99415-99416 for prolonged clinical staff services if the documentation of the time spent by the staff face-to-face with the patient meets the code definitions. If the staff is just checking blood pressure periodically, that would likely not meet the threshold for these codes.

The codes labeled as 'observation' E&M services do not qualify as those are for patient formally admitted to observation status in a facility - they would not apply to observation in an office setting.
 

jhendrix08

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Thanks very much for taking the time to respond to my question. You both confirmed what I was thinking...I appreciate your advice!
 
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