Hello,
I am hoping I can get some feedback regarding the coding and billing of Hospital Observation codes for Medicaid patients.
According to the HFS Handbook for Practitioners (Observation Section A-220.4) - http://www.hfs.illinois.gov/assets/a200.pdf - "Payment will not be allowed for observation care for consecutive dates of service. Also, only one observation CPT Code may be billed. The observation care "discharge" is not a covered service."
Since Medicaid does not accept Observation subsequent visits and discharge, would alternative coding be acceptable? For example, bill outpatient established visit codes (99211-99215) instead of observation subsequent codes and discharge (99224-99226/99217)?
Mary V., RHIA, CPMA
I am hoping I can get some feedback regarding the coding and billing of Hospital Observation codes for Medicaid patients.
According to the HFS Handbook for Practitioners (Observation Section A-220.4) - http://www.hfs.illinois.gov/assets/a200.pdf - "Payment will not be allowed for observation care for consecutive dates of service. Also, only one observation CPT Code may be billed. The observation care "discharge" is not a covered service."
Since Medicaid does not accept Observation subsequent visits and discharge, would alternative coding be acceptable? For example, bill outpatient established visit codes (99211-99215) instead of observation subsequent codes and discharge (99224-99226/99217)?
Mary V., RHIA, CPMA