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observation codes 2nd request


Best answers

I am hoping someone can help regarding coding of observation status. I am located in Pennsylvania and my understanding is that Medicaid does not pay for any observation codes? Is this true and if so what code should be used, outpatient visit codes?? Any insight is appreciated.


Kelly Alexander CPC
Bradenton, Florida
Best answers
In light of PA Medicaid's policy the only compliant alternative coding would be outpatient visit codes based on if the patient is new or established with your providers/practice.

You will find the formal guidance in the PA State Code. I pasted a link below. You will need to spend some time researching to find the actual provision. I am not postive if it is in this chapter but makes the most sense.


Good Luck!