Wiki Observation Time Frame?

[634sg4fs65g4fg]

I am coding a hospital charge and the hospital's facesheet states patient admitted on 05/10 as observation status until 05/13, Isn't that more than allowed? I thought it was 48hrs until considered inpatient? My doctor is the admitting dr. and patient has Medicare so I coded it 99218 for admit w/AI, then day two I did 99219 for level 2, day three I did 99218 for level one and for discharge I did 99217. It states observation is for e and m of patient per day so is this appropriate? Thanks,Gail

 

[RebeccaWoodward*]

I am coding a hospital charge and the hospital's facesheet states patient admitted on 05/10 as observation status until 05/13, Isn't that more than allowed? I thought it was 48hrs until considered inpatient? My doctor is the admitting dr. and patient has Medicare so I coded it 99218 for admit w/AI, then day two I did 99219 for level 2, day three I did 99218 for level one and for discharge I did 99217. It states observation is for e and m of patient per day so is this appropriate? Thanks,Gail

In the rare circumstance when a patient receives observation services for more than 2 calendar dates, the physician shall bill a visit furnished before the discharge date using the outpatient/office visit codes. The physician may not use the subsequent hospital care codes since the patient is not an inpatient of the hospital.

http://www.cms.gov/manuals/downloads/clm104c12.pdf

(Page 46)

So...in your case, it would look something like this (example only)-

Day 1=99218
Day 2=99212-99215
Day 3=discharge 99217

.

 

[634sg4fs65g4fg]

I didn't realize we could code both outpt/office and observation together, I thought I would have to bill each day with an observation code. I will give it a try, thank you!