Calendar holds key to proper billing - and payment - for observation

Why This Topic Matters

Observation billing can affect claim acceptance, compliance, and reimbursement. The article helps readers understand the general framework Medicare uses so they can evaluate whether an observation claim is likely to be properly supported.

Article Sections

1. Medicare observation billing overview

   Introduces the topic of physician Part B payment for observation and explains why the Medicare rules are a source of confusion. It also identifies the specialties that commonly submit these claims.

2. Calendar date and timing considerations

   Discusses how the calendar date affects billing decisions and why elapsed time matters in observation reporting. The section also presents differing viewpoints on when physician-related timing begins.

3. Documentation and physician involvement

   Summarizes documentation expectations discussed in the article, including physician presence, orders, and recordkeeping. It emphasizes the compliance significance of supporting evidence in the medical record.

4. Bundling and separate reporting considerations

   Reviews situations in which observation may be considered part of another service and situations where separate reporting may be considered. It also addresses related evaluation and management and critical care considerations.