Initial Observation services

Pgomez76

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Hello All,

I was wondering if someone could tell me; I would like to know if anyone knows where in the CPT or anywhere it states that when coding for Intial observation services if the patient has been there more than 48 hours to code from the Office visit codes 99212-99215? I would really appreciate your help.
 

MnTwins29

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All of the Initial Observation codes are per day- nothing noted about 48 hours - are you thinking of when a physician other than the supervision physician performs an E/M service for a patient in observation? In those cases, the other physician will use the appropriate Office/Outpatient E/M code.
 

RebeccaWoodward*

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In the rare circumstance when a patient is held in observation status for more than 2 calendar dates, the physician shall bill a visit furnished before the discharge date using the outpatient/office visit codes. The physician may not use the subsequent hospital care codes since the patient is not an inpatient of the hospital.

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

30.6.8 Section C
 
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Fontana
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hopefully you can help me...what if the patient is in obs status for 16 days....how are the subsequent visits supposed to be coded???this patient is Medicare Part A only.

In the rare circumstance when a patient is held in observation status for more than 2 calendar dates, the physician shall bill a visit furnished before the discharge date using the outpatient/office visit codes. The physician may not use the subsequent hospital care codes since the patient is not an inpatient of the hospital.

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

30.6.8 Section C
 
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