ED vs Obersvation

ghiocel

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What Place of service would you use if a patient is coming through ED and stay under Observation care for a couple days? Will you use -23 for the entire stay or -22
 

thomas7331

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The place of service should reflect the patient's status at the time the services were rendered. So 23 for services during the patient's time in the ED and 22 after the admission to observation. I believe the patient's status would officially change to observation at the time the order for observation care was made by the provider.
 
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If the patient was evaluated in the ED and the provider subsequently decided to place the patient in observation, there would be no ED charges. The ED provider who made the decision to admit to obs bills for the initial obs code only, but can include any work done while the patient was in the ED when leveling that initial obs code.

I know someone else had an issue with a claim denying for the date and place of service in this exact same situation. Since all the work performed in the ED is included in the admit, it falls under observation (because "observation" doesn't have a specific location)
 
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