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Observation Codes

  1. Default Observation Codes
    Medical Coding Books
    If a patient is admitted to observation one day(orders given via phone) but the physician does not see the patient until the next day and discharges him, can we bill 99234-99236 codes even though it was a different calendar day?

  2. #2
    Default
    Look at 99217. Per AMA CPT book "Observation discharge of a patient from Observation status includes final exam of the patient, discussion of the hospital stay, instructions for continuing care, and preperation of discharge records." Also look on page 13 of the 2009 AMA CPT book at the paragraph directly above the 99234 code and that directs you to the 99217 code for a different discharge date. 99234-99236 is for Observation on the same date of service. Hope this helps

  3. #3
    Location
    Milwaukee WI
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    4,466
    Default Date of service
    The date of service is when the physician actually sees the patient. If patient "admitted" (via phone call) to observation on 6-15-09, but doctor did not see patient until 6-16-09, at which time doctor also wrote discharge order, then, yes, you could use the 99234-99236 code (as per documentation) to describe the service provided by the physician on date of service 6-16-09.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  4. #4
    Default
    Tessa, I guess I am confused...please help. Why would it not be 99217. What am I missing??

  5. #5
    Location
    Milwaukee WI
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    4,466
    Default Admit/discharge on same date of service
    It would not be 99217 in the example I gave because ALL the services (both the admit visit and the discharge) were performed on the same date of service.

    Of course, this is dependent on documentation (as are all services).

    F Tessa Bartels, CPC, CEMC
    Last edited by FTessaBartels; 07-15-2009 at 04:07 PM.

  6. #6
    Location
    Greeley, Colorado
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    2,045
    Default
    Tessa - I am wondering the same thing as Leslie. If an actual admission by the doctor was not performed on the date the hospital shows the patient as being admitted (to observation); and the doctor did the discharge the following day, wouldn't the correct code be 99217 since the patient was in observation over 2 dates? My understanding of 99234-99236 is that the patient is admitted and discharged on the same date; in this example the patient is admitted on day one and discharged on day two. Thoughts?
    Lisa Bledsoe, CPC, CPMA

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