Wiki Medicare Consults for Observation Status

[bedforak1]

Can anyone clarify the following senario for me? I have a Medicare patient that is admitted into observation status on 5/21. My physician is asked to consult the patient on 5/22. What series of codes do I use? Initial Obs codes or 99210-99215 codes?

 

[OCD_coder]

Per the Medicare guidelines, only the admitting provider can bill the Observation code sets.

Your consulting provider will focus on the outpatient New/Established code sets based on the status of the patient to the provider.

 

[bedforak1]

So, they would not report the subsequent care series of codes? 99224-99226

 

[RebeccaCross*]

So, they would not report the subsequent care series of codes? 99224-99226

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Payment for an initial observation care code is for all the care rendered by the ordering physician on the date the patient?s observation services began. All other physicians who furnish consultations or additional evaluations or services while the patient is receiving hospital outpatient observation services must bill the appropriate outpatient service codes.

For example, if an internist orders observation services and asks another physician to additionally evaluate the patient, only the internist may bill the initial and subsequent observation care codes. The other physician who evaluates the patient must bill the new or established office or other outpatient visit codes as appropriate.

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf