Results 1 to 5 of 5

23 hour stay/Observation services

  1. Default 23 hour stay/Observation services
    Medical Coding Books
    Help!!!! Is anyone out there billing for 23 hour stays/observation services???

    I could really use some guidance on codes to use and documentation required for reimbursement. I believe the codes to use are G0378 and G0379 but are there any other options?

  2. Default
    I need some guidance in the same thing, any one? can ASC bill for 6 hour guidance even?

  3. Default
    i would code G0378 and G0379 for the observation hours accordingly.
    Ahmed Shaffi. N ,CPC

  4. #4
    Default G0379-Direct Referral
    Can anyone help me understand if the G0379-direct referral always has to be present with G0378 if the patient did not go to hospital oupatient clinic, ED, or critical care on the day of initiation of OBS services? I'm trying to figure out if we can bill G0378 by itself for OBS hours without the direct referral. The information I am finding is that hospitals should report G0379 WHEN a patient is referred directly to obs care after being seen by a physician in the community. It doesn't sound to me like they have to have a direct referral ALWAYS when they come to OBS, even if they were not seen in hospital outpatient clinic, ED, or critical care the same dos.

  5. Default
    G0378 is billable alone, per hour of observation. G0379 is billed as a unit of 1 when there has been a direct referral from a physician to observation status or care, in addition to G0378 for the hours of observation care. If you go to the CMS website, internet only manual section, Claims Processing Manual Chapter 4, begin with section 290. It will give you all of the guidance on billing hospital observation services. Remember to carve out those hours of observation care if a patient receives a therapeutic service that requires active monitoring.

Similar Threads

  1. CMHC 23 hour observation
    By Colleen47 in forum Medicare Regulations
    Replies: 0
    Last Post: 06-17-2015, 09:52 PM
  2. Observation Stay
    By Linda77 in forum Outpatient Facilities
    Replies: 2
    Last Post: 01-14-2014, 11:36 AM
  3. 23 hour stay help!!!!!
    By banderson77 in forum Orthopaedics
    Replies: 1
    Last Post: 12-19-2011, 01:34 PM
  4. 23 Hour Observation
    By mattamyc in forum Outpatient Facilities
    Replies: 2
    Last Post: 05-06-2011, 10:43 AM

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?


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.