G0379/Do you use this?

RebeccaWoodward*

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Hi guys,

I am in unfamiliar territory. My new physician is trying to use G0379. I have never used this code for provider billing. I have done some research and if I understand this correctly... the hospital bills for this?:confused:

290.5.2 - Billing and Payment for Direct Admission to Observation Care Beginning January 1, 2008

Direct admission to observation care continues to be reported using HCPCS code G0379 (Direct admission of patient for hospital observation care). Hospitals should report G0379 when observation services are the result of a direct admission to observation care without an associated emergency room visit, hospital outpatient clinic visit, or critical care service on the day of initiation of observation services. Hospitals should only report HCPCS code G0379 when a patient is admitted directly to observation care after being seen by a physician in the community.

http://www.cms.hhs.gov/manuals/downloads/clm104c04.pdf

My physician would bill the appropriate hospital code from the E/M section of the CPT book, correct? Does anyone have any experience with this G code?
 

mbort

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I agree with you Rebecca. After reviewing the information you posted, this appears to be a hospital code, not physician.
 

Anna Weaver

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G0379

Rebecca,
I agree with you. Here's what Coding Clinic says:

Hospitals should report code G0379 when observation services are the result of a direct admission to observation status without an associated emergency department visit, outpatient clinic visit or critical care service on the day of, or day before, the observation services.

It's important for hospitals to consistently report these codes whether the observation would be packaged or separately payable. Data available from the reporting of these codes will assist CMS in developing consistent and complete hospital claims data regarding the utilization and costs of observation services.

Hospitals should not report CPT observation codes (99218-99220 or 99234-99236) because these codes will not be recognized for payment (separate or packaged) under the OPPS in CY 2006.
 
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