Results 1 to 3 of 3

Observation Status-Orthopedic surgeon

  1. #1
    Default Observation Status-Orthopedic surgeon
    Clearnace Sale
    Orthopedic surgeon is asked to see a patient who is in the hospital under "observation" status. The patient is there for 3 days. Doctor sees the patient each day. What code series should be billed for day 1.... what code series for each additional day ? Also for claim submission would the Place of Service be "outpatient" or "inpatient" ?
    Lots of different opinions on this scenario going on here regarding correct way to bill.
    Thanks for any feedback !

  2. #2
    Who is your carrier? Was it a consult or transfer of care?

    For Medicare, I just sat thru a webinar from Highmark Medicare, stating that in obs you only use the outpatient E/Ms unless you are the provider that put them in obs (99201-99215). I am going to research this for other carriers though since this is the first I had heard of it.

    For commercials, if you have a consult you would use the outpatient consult (99241-99245) for day 1 then established outpatient 99212-99215 for days 2 and 3. If it was a transfer of care you would use the correct outpatient E/M (99201-99215) for day 1 then the established outpatients for days 2 and 3.

    Laura, CPC, CPMA, CEMC

  3. #3
    For this case Medicare is the carrier and it was a consult.

Similar Threads

  1. Observation Status
    By mcoder30 in forum E/M
    Replies: 2
    Last Post: 10-23-2014, 07:32 AM
  2. Replies: 0
    Last Post: 06-15-2012, 09:29 AM
  3. From ER to Observation status
    By pvang in forum Emergency Department
    Replies: 2
    Last Post: 01-04-2011, 11:25 AM
  4. Observation status
    By kmcafee in forum E/M
    Replies: 2
    Last Post: 08-31-2010, 10:52 AM
  5. Observation Status
    By dsmith06351 in forum E/M
    Replies: 1
    Last Post: 08-07-2009, 11:57 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.