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Outpatient (obersvation) Help

  1. #1
    Default Outpatient (obersvation) Help
    Medical Coding Books



    Hello,

    I am looking for some help selecting the appropriate E&M code for my doctor.

    The patient was seen at the hospital by one of our physicians, however she was not the admitting physician. The facesheet from the hospital says outpatient which to me is like observation.

    From what I read, 99220 would not be appropriate because my physician did not admit the patient. And 99236 seems like it should be for an admit and discharge on the same day.

    She saw the patient each day and on the second day discharged her.

    I am confused on what code I should use for the first time our physician saw the patient and also for the second visit as well.

    Any help would be appreciated.

    Thanks!

  2. #2
    Default
    Quote Originally Posted by NVobgynCoder View Post



    Hello,

    I am looking for some help selecting the appropriate E&M code for my doctor.

    The patient was seen at the hospital by one of our physicians, however she was not the admitting physician. The facesheet from the hospital says outpatient which to me is like observation.

    From what I read, 99220 would not be appropriate because my physician did not admit the patient. And 99236 seems like it should be for an admit and discharge on the same day.

    She saw the patient each day and on the second day discharged her.

    I am confused on what code I should use for the first time our physician saw the patient and also for the second visit as well.

    Any help would be appreciated.

    Thanks!
    See the guidelines on page 13 of the CPT; It sounds like the patient was in observation for 2 days; if your provider didn't admit the patient into observation status, you'll more than likely report an Outpatient Consult code, or a subsequent Observation code (99224-99226) for the first day; you'll report 99217 for the discharge.

    Hope that helps!

  3. #3
    Location
    Ellenville, New York
    Posts
    1,177
    Default Verfiy inpatient or outpatient
    Don't take the word of the facesheet you were provided, as it might have been printed while the patient was in observation and if she was subsequently admitted, then that status would have changed. Do you have a way to verify if the patient was ever admitted?
    Last edited by MnTwins29; 02-09-2012 at 08:13 AM. Reason: grammar

    Lance Smith, MPA, COC, CPMA, CEMC, RHIT, CCS-P, CHC, CHPC

    Director, Health Information Management
    HealthAlliance of the Hudson Valley
    Kingston, NY


    2016 Secretary
    Ellenville, NY Local Chapter

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