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Emergency visit plus observation

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2
Best answers
0
What has been your experience with billing both ER visit then observation code on the same date, plus what is Medicare guidelines state? Thank you
 

jimbo1231

Expert
Messages
370
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0
One scenario (maybe)

The only scenario I can think of is that the patient comes to the ED on a given calendar date say 12/1. They are in the ED until 12/2 when they are admittted to Observation. CPT states that " Emergency Department.....are considered part of Observation Care when performed on the same date". So in the above scenario, on two separate calendar dates, you could code both. But getting paid without solid documentation to back it up could be another story.

Jim
 

nandhakumar

Networker
Messages
53
Best answers
0
Hi..

The patient came to Ed on 12/1 and stayed in observation unit on 12/1 and discharged on 12/2 then we will be coding it as 99220-99218 for 12/1 dos and 99217 for 12/2 dos.

If the patient came to ED on 12/1 and stayed on observation unit on 12/2 and discharged on 12/2 then we have to code appropriate ed level for 12/1 and for 12/2 if it qualify for 8 hours then we have to code same day observation code.
 
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