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Observation help needed

  1. #1
    Default Observation help needed
    Exam Training Packages
    If the facility doesn't bill for observation (they're billing erm,rev code 450) , is it okay for the physician to bill an observation E&M (99236) ? Can anyone point me in the right location to do this reseach.

  2. #2
    Location
    Columbia, MO
    Posts
    12,570
    Default
    no it has to be the same for both. If the physician wrote an order to admit to observation then it is observation and the facility must bill it that way with an obs rev code. If no order was written then your physican must bill an ER encounter. A visit/encounter must clearly be one or the other and not different things to different billiers.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default Documentation,please
    Can you give me a place where I can verify this ? Is this just your interpretation ? I don't want to retract $$ for billing incorrectly, I need the documentation to back it up. Thanks

  4. #4
    Location
    Columbia, MO
    Posts
    12,570
    Default
    I do not have a ready link for you but go to the CMS website and search for observation. You cannot just bill observation it must be a status ordered by the physician.

    Debra A. Mitchell, MSPH, CPC-H

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