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Thread: new observational codes

  1. #1

    Default new observational codes

    AAPC: Back to School
    does medicare accept these new CPT codes 99244,99245, 99226?


  2. #2
    Join Date
    Apr 2007
    North Carolina


    Quote Originally Posted by Robinznest View Post
    does medicare accept these new CPT codes 99244,99245, 99226?

    Medicare does not accept any consultation codes (99244, 99245) as of 1-1-2010. Medicare does accept 99226 if the provider was also the admitting provider (99218-99220).

    30.6.10: Consultations


    Obs: 30.6.8

    Payment for an initial observation care code is for all the care rendered by the ordering physician on the date the patient’s observation services began. All other physicians who furnish consultations or additional evaluations or services while the patient is receiving hospital outpatient observation services must bill the appropriate outpatient service codes.

  3. #3
    Join Date
    Apr 2007
    Sarasota FL

    Default Observation codes.

    These are billed in different ways according to Medicare contractor policies..it would be too simple for all contractors to follow the same rules of course.
    Here in Florida they can be billed to any provider who does a consult and then sees the patient for follow-up visits whereas other contractors say they can only be billed by the admitting provider and all others must use the regular office visit codes.
    It has taken us 4 months to find this out. In my humble but probably worthless opinion, we should all have been given guidance by our contractors as to how to bill these codes. I e-mailed our local contractor and was told that I would get a reply in 45 business days because they were very busy. I wonder why. Maybe coders were trying to get the info THEY should have given us in the first place.
    I feel better for a good vent.

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