DecisionHealth, DecisionHealth - 2012 Issue 8 (August)

Learn differences between CMS, CPT advice on observation coding to avoid errors

Get full reimbursement for observation services by paying close attention to the subtle but essential differences between Medicare requirements and CPT guidance. That allows you to tailor your coding to government-covered patients and to those on private plans. CMS claims data indicates observation services billing continues to cause headaches, as the 2010 denial rates for observation codes (99217-99220, 99234-99236) range from 8.0% to 13.9% (PBN 6/11/12). Note: Data for subsequent observation codes, which were introduced in 2011, are not yet available.

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