The last issue of Coding Clinic for HCPCS addressed the proposed HCPCS G codes for direct admissions to observation, published in the August 9, 2002 proposed rule.
G codes G0LLL and G0MMM were proposed to assist in the reporting of initial nursing assessment of patients directly admitted to observation.
Based on the comments received regarding these G codes, CMS has decided to implement two new G codes, G0263, Direct admission of patient with diagnosis of congestive heart failure, chest pain or asthma for observation, and G0264, Initial nursing assessment of patient directly admitted to observation with diagnosis other than congestive heart failure, chest pain, or asthma, to report direct admissions to observation. These codes have been created to simplify the reporting of direct admissions to observation.
For example: A patient could place a phone call to the physician, which prompts the physician to call the hospital and order a direct admission to observation for the patient.
As long as the physician notifies the hospital that he/she is ordering the direct admission of the patient for observation and supports that order with the appropriate suspected diagnosis, it is believed that this would constitute a direct admission.