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Observation help needed

K

ksimpson

Contributor
Messages
11
Location
Rockland, MA
If the facility doesn't bill for observation (they're billing erm,rev code 450) , is it okay for the physician to bill an observation E&M (99236) ? Can anyone point me in the right location to do this reseach.
 
no it has to be the same for both. If the physician wrote an order to admit to observation then it is observation and the facility must bill it that way with an obs rev code. If no order was written then your physican must bill an ER encounter. A visit/encounter must clearly be one or the other and not different things to different billiers.
 
Documentation,please

Can you give me a place where I can verify this ? Is this just your interpretation ? I don't want to retract $$ for billing incorrectly, I need the documentation to back it up. Thanks
 
I do not have a ready link for you but go to the CMS website and search for observation. You cannot just bill observation it must be a status ordered by the physician.
 
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