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Medicare and subsequent Obs Care

  1. Default Medicare and subsequent Obs Care
    Medical Coding Books
    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.

    Nichole Ramsey

  2. #2
    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.
    Jenny Berkshire, CPC, CEMC, CGIC

  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?


  4. #4
    That's right.
    Jenny Berkshire, CPC, CEMC, CGIC

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