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Wiki Observation coding

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ksoutherland

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I have a patient who was admitted to observation late on 11/28, then on 11/29 our doctor dictated both the H&P and the discharge. It is my understanding we cannot bill both so we billed the 99217 discharge. Insurance denied stating to "resubmit the claim with the qualifying service". Should we be billing the H&P instead? Seems like I've been getting a lot of denials lately related to observation. Have there been changes?
 
ksoutherland said:
I have a patient who was admitted to observation late on 11/28, then on 11/29 our doctor dictated both the H&P and the discharge. It is my understanding we cannot bill both so we billed the 99217 discharge. Insurance denied stating to "resubmit the claim with the qualifying service". Should we be billing the H&P instead? Seems like I've been getting a lot of denials lately related to observation. Have there been changes?
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Look at the codeset 99234-99236-Observation Care Services for Same Day Admit and Discharge; looks like this is what you'll need to use.
 
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