Wiki Medicare and subsequent Obs Care

[cnramsey]

I thought Medicare accepted cpt codes 99224-99226 for subsequent obs visits. But the other coder in the hospital thought Medicare didn't accept these codes. Needs some input on this subject please.

Thanks
Nichole Ramsey

 

[j.berkshire]

Yes, Medicare accepts the subsequent observation codes. These must be billed by the provider admitting the patient to observation. Other providers providing observation followup are instructed to bill using the office/outpatient codes. See the IOM #100-04, Chapter 12, Section 30.6.8. http://www.cms.gov/manuals/downloads/clm104c12.pdf

 

[cnramsey]

Subsequent Obs

So that would mean if Dr A saw admitted patient he would get 99218-99220 and if he's also the provider that saw the patient up to their discharge I would use codes 99224-99226 for their subsequent obs care visits. But if Dr B provides the subsequent visit I would use 99211-99215 instead?

Thanks
Nichole

 

[j.berkshire]

That's right.