DecisionHealth, DecisionHealth - 2011 Issue 1 (January)

Aetna sides with CMS against CPT on subsequent observation codes

CMS won’t reduce your pay by making you bill CPT’s new subsequent observation codes when your doctor evaluates a patient that someone else placed under observation. But CPT has made it clear that its intention was for the new codes (99224-99226) to be used in this situation, despite the fact they pay about 40% less than the codes CMS instructs you to use for Medicare claims.

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