Results 1 to 3 of 3

Who can use Observation codes??

  1. Default Who can use Observation codes??
    Medical Coding Books
    Is it true that only the admitting physician can use the Observation code series 99234 - 99238?
    For example, another Physician asks a Cardiologist to see a patient that is in observation status for Chest Pain. The Cardiologist is not the admitting physician. Since the Cardiologist is not the admitting physician and the patient is in observation status then the Cardiologist must use the code series for the Office or Other Outpatient series (99201-99205 or 99212-99215), correct??

  2. #2
    Default
    Quote Originally Posted by cvand1972 View Post
    Is it true that only the admitting physician can use the Observation code series 99234 - 99238?
    For example, another Physician asks a Cardiologist to see a patient that is in observation status for Chest Pain. The Cardiologist is not the admitting physician. Since the Cardiologist is not the admitting physician and the patient is in observation status then the Cardiologist must use the code series for the Office or Other Outpatient series (99201-99205 or 99212-99215), correct??
    Read the guidelines in green under "Initial Observation Care" - they direct you to use 99241-99245, or 99224-99226 as appropriate, for physicians who see the patient while in observation status, when they aren't the admitting physician. Hope that helps!

  3. #3
    Location
    North Carolina
    Posts
    3,126
    Default
    FYI....Medicare doesn't follow CPT's guidelines.

    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.

    For example, if an internist orders observation services and asks another physician to additionally evaluate the patient, only the internist may bill the initial observation care code. The other physician who evaluates the patient must bill the new or established office or other outpatient visit codes as appropriate.

    Pg 52

    http://www.cms.gov/manuals/downloads/clm104c12.pdf

Similar Threads

  1. Observation Codes
    By nantes1993 in forum E/M
    Replies: 3
    Last Post: 12-04-2015, 02:07 PM
  2. Observation Codes
    By Bellaboo in forum E/M
    Replies: 2
    Last Post: 05-16-2013, 01:36 PM
  3. observation codes-can anybody
    By uncapooh in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-18-2010, 03:15 PM
  4. Observation codes-coding hospital charges
    By AFisher in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 04-07-2010, 07:52 AM
  5. Observation codes
    By Beany011178 in forum E/M
    Replies: 4
    Last Post: 09-09-2008, 04:10 PM

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?

Login

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.