Results 1 to 3 of 3

Observation coding HELP!!!

  1. Default Observation coding HELP!!!
    Exam Training Packages
    Can anyone tell me the rules for Observation coding. If a patient comes in to the ER and is admited to Observation on the same day, are these considered 1 encounter or 2 encounters? (1 per department)

    Need help.

  2. #2
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by lparrish View Post
    Can anyone tell me the rules for Observation coding. If a patient comes in to the ER and is admited to Observation on the same day, are these considered 1 encounter or 2 encounters? (1 per department)

    Need help.
    CPT book guidelines page 13:
    "When "observation status" is initiated in the course of an encounter in another site of service (eg, hospital emergency department, physician's office, nursing facility) all evaluation and management services provided by the supervising physician in conjunction with initiating "observation status" are considered part of the initial observation care when performed on the same date.

    So if the same doctor saw them in the ER and then admitted them to observation, only one E/M code is reported for the day. If two different physicians provided the services then you can report two separate codes, 1-ER and 1-observation status.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3
    Location
    Milwaukee WI
    Posts
    4,466
    Default When are Two doctors considered ONE?
    Arlene is correct -- except ...

    If the two different physicians who saw the patient are of the same practice AND the same specialty, they are considered ONE physician. In which case only the Initial Observation Care service can be charged, though you can use ALL the documentation to arrive at the appropriate level.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. Observation Coding - I have a question related
    By dbouchelle in forum Billing/Reimbursement
    Replies: 0
    Last Post: 11-19-2014, 09:19 AM
  2. Observation coding
    By ksoutherland in forum Employment General Discussion
    Replies: 1
    Last Post: 02-27-2012, 03:29 PM
  3. Observation coding.
    By dgiretto in forum ENT/Otolaryngology
    Replies: 3
    Last Post: 12-05-2011, 06:23 PM
  4. Observation coding
    By glenski91175 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 03-25-2010, 09:12 AM
  5. Replies: 1
    Last Post: 10-27-2009, 01:32 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.