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Thread: 23 hour stay/Observation services

  1. #1

    Default 23 hour stay/Observation services

    AAPC: Back to School
    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. #2


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

  3. #3


    i would code G0378 and G0379 for the observation hours accordingly.

  4. #4
    Join Date
    Apr 2007

    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. #5


    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.

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