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Thread: Medicare and subsequent Obs Care

  1. #1

    Default Medicare and subsequent Obs Care

    I thought Medicare accepted cpt codes 99224-99226 for subsequent obs visits. But the other coder in the hospital thought Medicare didn't accept these codes. Needs some input on this subject please.

    Thanks
    Nichole Ramsey

  2. #2
    Join Date
    Apr 2007
    Location
    Dayton
    Posts
    241

    Default

    Yes, Medicare accepts the subsequent observation codes. These must be billed by the provider admitting the patient to observation. Other providers providing observation followup are instructed to bill using the office/outpatient codes. See the IOM #100-04, Chapter 12, Section 30.6.8. http://www.cms.gov/manuals/downloads/clm104c12.pdf
    Jenny Berkshire, CPC, CEMC, CGIC

  3. #3

    Default Subsequent Obs

    So that would mean if Dr A saw admitted patient he would get 99218-99220 and if he's also the provider that saw the patient up to their discharge I would use codes 99224-99226 for their subsequent obs care visits. But if Dr B provides the subsequent visit I would use 99211-99215 instead?

    Thanks
    Nichole

  4. #4
    Join Date
    Apr 2007
    Location
    Dayton
    Posts
    241

    Default

    2017 ICD-10-CM Coding Book
    That's right.
    Jenny Berkshire, CPC, CEMC, CGIC

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