Wiki Observation Codes.

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nikkisgranny

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I am not sure if I can use the observation codes or not. Here is the situation: Patient was admitted originally as an inpatient for a hip reduction then changed to outpatient and was held in observation.

Can I charge 27266 with an observation code 99218-99220?
 
When was the decision for surgery made? If it was made at the time the patient was admitted and not prior to, then you can code an obs admit with mod -57. UNLESS this is a Medicare patient and you are still in the global for the arthroplasty, then only 27266 can be coded (assuming this is the same physician who did the arthroplasty).
 
observation

if for the physician then you would need a modifier 50 or 51 on code 27266, if for facility then you would need modifier 57 on 27266, u will need to justify the use of 57.
 
Decision for surgery was made at time of admission-not prior. No global date. Last DOS 5/20/08. Patient apparently has problems with dislocation of hip prosthesis.

So I would code:

27266
99218

Doc has to dictate why patient was held in observation status correct?
 
Finding out more with this observation status.

The patient has had three recurrent hip dislocations. She was put in observation status to get a brace measured and fitted for such.

Reading the CPT guidelines: "These codes may nt be utilized for post-operative recovery if the procedure is considered part of the surgical "package."

I am not quite sure whether measuring and fitting for a brace due to recurrent hip dislocations constitutes as being immediate postoperative care.

Any other suggestions?
 
nikkisgranny said:
Finding out more with this observation status.

The patient has had three recurrent hip dislocations. She was put in observation status to get a brace measured and fitted for such.

Reading the CPT guidelines: "These codes may nt be utilized for post-operative recovery if the procedure is considered part of the surgical "package."

I am not quite sure whether measuring and fitting for a brace due to recurrent hip dislocations constitutes as being immediate postoperative care.

Any other suggestions?
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I responded to your PM ;)
 
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