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Admission for Observation care after PTCA/stent

  1. Default Admission for Observation care after PTCA/stent
    Medical Coding Books
    Can I bill the Initial obervation care code (99234-99236) if the patient was scheduled for a heart cath that led to the patient having PTCA/stent. The patient needed to be kept in the hospital overnight for observation & then bill a discharge (99217) the next day?

  2. Default OBSERVATION E/M codes
    The 99234-99236 codes are used when admitted and dismissed on the same date of service. But for an OBS admission on day 1 with OBS dismissal on day 2, the 99218-99220 apply for day 1 of OBS and 99217 would apply for OBS date of dismissal. Does this clarify a bit I hope? If not, please write back and we will discuss further, thanks.

  3. Default
    Thanks for the correction in the CPT code.

    But my main concern is can we bill the Initial obervation care code (99218-99220) if the patient was scheduled for a heart cath that led to the patient having PTCA/stent. The patient needed to be kept in the hospital overnight for observation & then bill a discharge (99217) the next day?

  4. #4
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    Default
    Quote Originally Posted by peeya View Post
    Thanks for the correction in the CPT code.

    But my main concern is can we bill the Initial obervation care code (99218-99220) if the patient was scheduled for a heart cath that led to the patient having PTCA/stent. The patient needed to be kept in the hospital overnight for observation & then bill a discharge (99217) the next day?
    Yes, you can bill for the observation care provided the same day as the procedure.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  5. Default
    Quote Originally Posted by ajs View Post
    Yes, you can bill for the observation care provided the same day as the procedure.
    Peeya,
    99234-99236 are admit/discharge codes for the same day. This patient was not admitted and discharged the same day right? So no you cannot use this set of codes at all.

    Now if this was a scheduled heart cath which led to the placement of a stent. The patient was seen in the office(since the cath was scheduled) and a H&P was done and billed. Then no you cannot bill an initial observation code(99218-99220) either. You can bill the discharge code 99217 the day after the heart cath/stent was done.

    Hope this helps,Confusing I know.
    Theresa CCS-P CPMA CCC ICDCT-CM

  6. Default
    Thanks a ton..

  7. #7
    Default
    I would use a 25 modifier on the observation code to show that it was separate from the procedure.
    Chrissy, CPC

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