Wiki Facility Observation Coding

[bella2]

Hi,
I'm looking for a little assistance, I'm a Hospital Outpatient Surgery Coder, so I'm very familiar with my CPT codes for surgery. But now I'll also be coding Observation accounts for the hospital. I'm hoping for verification on this for Medicare procedures such as a cholecystectomy I'll continue to use CPT codes, but for commercial payers I'll be using ICD-10-PCS for procedures ?
Thanks in advance for all responses.

 

[thomas7331]

ICD-10-PCS is for inpatient facility claims only - you will not use these for any payers for outpatient or observation coding.

Observation coding is really no different from outpatient surgery coding - the main difference is that the claims will include, in addition to surgical procedures, any emergency room services, diagnostic tests, observation hours and any also drug infusion codes that are not incidental to another procedure. Your facility will need to provide you internal guidelines on how they charge and code these items, because there is a lot of variation in this from one facility to another.