decisionhealth Newsletters, Part B News - 2009 Issue 7 (July)
MedPAC: Physicians keeping patients in observation care longer
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Article Overview
This article reviews trends in hospital observation care, including growth in utilization, Medicare payment context, and scrutiny from payers and oversight entities. It is written for coding, billing, and compliance professionals who monitor outpatient hospital E/M services and Medicare policy changes.
Why This Topic Matters
Observation services have become a higher-volume and higher-scrutiny area for hospitals and physicians, making accurate coding and compliance awareness important for billing integrity and audit readiness.
Article Sections
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Growth in observation care use
Summarizes reported increases in hospital observation activity over time and discusses the broader Medicare context behind that growth.
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Medicare payment and compliance scrutiny
Describes how observation services fit within Medicare payment policy and why carriers and oversight bodies are paying closer attention.
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Coding and billing overview for observation services
Reviews the general categories of observation-related hospital E/M services discussed in the article and the timing-related billing framework referenced by the source.
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Auditors taking note, observation is on the rise
Continues the discussion of utilization trends, denial activity, and heightened review of observation services by payers and auditors.
What You Will Learn
- How observation care trends have changed over time
- Why observation services are drawing increased audit attention
- How the article frames Medicare payment context for observation care
- What broad observation-related E/M service categories are discussed
Who Should Read This
- Medical coders
- Hospital outpatient billing staff
- Compliance professionals
- Physician practice managers
- Auditors and utilization reviewers
Codes Discussed
Code Ranges Discussed
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