jessica1974
Guru
Question for my fellow coding peeps: Medicare guidelines state that the only time we can bill the observation code is if we are the provider that admitted the patient to observation status. Am I correct on this information? And since we can't use the observation code we would use a new pt or est patient code. Am I correct on that information as well? The reason I am asking is that a payer (The Health Plan) wants us to use the observation code when the provider sees the patient in that setting. This is going against what I have been told. Now I am concerned that I have been doing this wrong. Anytime our provider sees a patient in observation, unless we admit them to obs which we rarely do, I use the new patient or established patient codes. I just want to reassure myself that I am doing this correctly. I appreciate all the help.
Signed Bewildered Coder..
Signed Bewildered Coder..