AHA Coding Clinic® for HCPCS - 2002 Issue 2; For your information

Reimbursement for observation services

No separate payment has been made for observation services since the beginning of OPPS. Observation services were packaged in the APC payment for the procedure or visit by which the observation service was provided. Now a separate APC payment for observation services for patients having diagnoses of chest pain, asthma, or congestive heart failure will be made to hospitals when certain additional criteria are met. Hospitals must use the new code G0244 for observation services that meet the criteria for separate payment and must submit the claim using bill type 13X. Contrary to information published in the OPPS Final...

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