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procedure during Observation Care

  1. #1
    Default procedure during Observation Care
    Exam Training Packages
    We have a patient who was admitted to Observation care on 8/2/11. They had a procedure with a global period on the same day. The procedure (46040) and Initial Observation (99219) were paid but the Subsequent Observation (99225) on 8/3/11 as well as the Observation Discharge (99217) on 8/4/11 were denied as part of the global. Can we bill the 99225 and 99217 after a procedure and expect pay or should we not be billing for those?

  2. #2
    Milwaukee WI
    Default Global
    All E/M services performed during the global period are included in the reimbursement for the procedure, UNLESS totally unrelated to the procedure.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    what if the procedure is a stent placement that has a zero-day global? Can you then bill for the subsequent day after the procedure (stent placement)? If so should you use the 99217 since they are being DC'd?
    Mary Beth Gord, CPC

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