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  1. Default observation
    Medical Coding Books
    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?

  2. #2
    Seacoast- Dover New Hampshire
    That a tough one. Was the pt in the ER first having test to determine if observation was needed?
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. Default
    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.

  4. #4
    Seacoast- Dover New Hampshire
    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?
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  5. Default
    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).

  6. #6
    Seacoast- Dover New Hampshire
    I would think you could, given the supporting documentation.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  7. #7
    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."

    Laura, CPC, CEMC

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

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