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Observation Coding

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So...a patient is placed in observation status at 10 p.m.
The physician does not see the patient until 11 a.m. and at that point decides to discharge the patient. Which OBS E/M code should the doc use?
I'm leaning towards 99217 for discharge since it is now a different calendar date so 99234-6 codes are ruled out and the patient has been in OBS for longer than 8 hours so by my thinking 99218-20 codes are ruled out but I'm not quite sure.
Your thoughts? Thanks.


True Blue
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Initial obs care day 1, discharge 99217 day 2... you're right, different calendar dates is key
Milwaukee WI
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Who admitted the patient to observation?

If you doctor never saw the patient on day 1, who admitted the patient to observation?

If the only charge on day one was an ER visit, then I would code 99234-99236 (depending on documentation) on day 2.

If another physician coded the admission to observation on day 1, then you are right, code the 99217 for day 2 visit.

F Tessa Bartels, CPC, CEMC