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Wiki Outpatient (obersvation) Help

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NVobgynCoder

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Sparks, NV
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:confused:


Hello,

I am looking for some help selecting the appropriate E&M code for my doctor.

The patient was seen at the hospital by one of our physicians, however she was not the admitting physician. The facesheet from the hospital says outpatient which to me is like observation.

From what I read, 99220 would not be appropriate because my physician did not admit the patient. And 99236 seems like it should be for an admit and discharge on the same day.

She saw the patient each day and on the second day discharged her.

I am confused on what code I should use for the first time our physician saw the patient and also for the second visit as well.

Any help would be appreciated.

Thanks!
 
NVobgynCoder said:
:confused:


Hello,

I am looking for some help selecting the appropriate E&M code for my doctor.

The patient was seen at the hospital by one of our physicians, however she was not the admitting physician. The facesheet from the hospital says outpatient which to me is like observation.

From what I read, 99220 would not be appropriate because my physician did not admit the patient. And 99236 seems like it should be for an admit and discharge on the same day.

She saw the patient each day and on the second day discharged her.

I am confused on what code I should use for the first time our physician saw the patient and also for the second visit as well.

Any help would be appreciated.

Thanks!
Click to expand...

See the guidelines on page 13 of the CPT; It sounds like the patient was in observation for 2 days; if your provider didn't admit the patient into observation status, you'll more than likely report an Outpatient Consult code, or a subsequent Observation code (99224-99226) for the first day; you'll report 99217 for the discharge.

Hope that helps! ;)
 
Verfiy inpatient or outpatient

Don't take the word of the facesheet you were provided, as it might have been printed while the patient was in observation and if she was subsequently admitted, then that status would have changed. Do you have a way to verify if the patient was ever admitted?
 
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