Wiki observation

[nc_coder]

If a pt goes in for obs at 10pm Monday and then is released at 2am Tuesday, would this count for one or two days?

 

[kbarron]

That a tough one. Was the pt in the ER first having test to determine if observation was needed?

 

[nc_coder]

This was a trauma pt, so I am assuming yes.
I don't actually have the notes with me. One of the other coders in my dept asked me about it.

 

[kbarron]

I would wonder if there is a consultation involved. Taking the consult code for getting the pt stable. Were they transfered to another facility? And, if the injuries were severe enough,are they really an IP?

 

[nc_coder]

No, definately not inpatient. I think what she is trying to determine is if she can do obs admit (99218-99220) and discharge on a separate day (99217) instead of admit and discharge same day (99234-99236).

 

[kbarron]

I would think you could, given the supporting documentation.

 

[LLovett]

Might depend on the carrier.

WPSMedicare only allows the 99234-99236 for patients in for more than 8 hours.

"Observation Care Codes
We have provided clarifying policy concerning use of observation care codes (99234-99236). To receive
payment for these codes, the patient must be in observation status for a minimum of 8 hours; otherwise,
only the admission code (99218-99220) should be billed."

http://www.wpsmedicare.com/part_b/publications/1200comm.pdf

Laura, CPC, CEMC

 

[nc_coder]

Thanks Laura. That was my statement exactly when I was asked the question- "It all depends on the carrier."