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Observation after Biopsy

  1. #1
    Question Observation after Biopsy
    Medical Coding Books
    Our nephrologist see patients in the hospital for observation after biopsy. They are not admitted and are in the hospital for less than 24 hours, but usually overnight. They want to bill Observation codes for these services. I have been in contact with our hospital and they do not place these patients in "observation status". Can I still bill observation codes? If not, should I bill the appropriate Office/Outpatient codes? Please let me know the correct way to bill for this.

    Thank you.

    Laura L. Porter, CPC
    Jamestown Area Medical Associates

  2. #2
    Milwaukee WI
    Default Who performed the biopsy?
    Who performed the biopsy? If the nephrologist did the procedure, then be sure to check the global period for the procedure. The "follow-up" visits while in observation may be global.

    F Tessa Bartels, CPC, CEMC

  3. #3
    I work for nephrologists also. We have been billing observation codes for a renal biopsy. When I schedule the biopsy, I schedule it as a 23 hour observation. (I'm not sure how the hospital admits the patient??)

  4. #4
    Our nephrologist don't perform the biopsy; therefore, the global period should not apply.

    The CPT guidelines for observation care state:

    ...evaluation and management services provided to patients designated/admitted as "observation status" in a hospital.

    We are just trying to find out if the hospital has to have them in "observation status", in order for the physicians to bill the observation codes.

    If anyone has information on this or knows of a web site we can visit to get information, please let me know.

    Thank you,
    Laura L. Porter, CPC
    Jamestown Area Medical Associates

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