Observation questions

carolhodge

Networker
Messages
71
Location
Richmond Hill, Georgia
Best answers
0
I need some confirmation of the way I have been billing the following two scenarios please. Any help would be greatly appreciated.

Medicare patient is admitted to observation by the attending physician. Cardiologist is consulted by the attending. This is a new patient to the cardiologist. The cardiologist see the patient in consultation and sees the patient again the next day in follow-up. How would you code both visits and what place of service would you use for each visit?

Patient is admitted to cardiologist services, either late in the day or for whatever reason, the cardiologist is unable to see the patient until the next day. Patient is also discharged the next day. What CPT code would you use for this one visit?

Thanks
Carol Hodge, CPC, CCC
 

Casper204

New
Messages
9
Location
Somers, CT
Best answers
0
In the first scenario, if the patient stayed observation status then it's considered hospital outpatient and you'd code using new patient codes 99201-99205 because of it being a medicare patient and you can't use consult codes. For the f/u the next day you'd use 99211-99215 for an outpt follow up. This is how I've coded it in the past where I work.

If the second case if it is also observation status, if the admit and discharge were done on the same day and your physician was the admitting physician, you can use the admit and discharge same day codes 99234-99236.
 
Top