tci ED Coding & Reimbursement Alert - 2001 Issue 8

You Be the Coder: Eight-Hour Rule

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer. Question: How does the "eight-hour rule" apply in coding for observation care?Arizona Subscriber Answer: If a patient's admission is less than eight hours, CPT requires using 99218-99220 (initial observation care, per day, for the E/M of a patient). If the patient is admitted and discharged within eight to 24 hours, use 99234-99236 (observation or inpatient hospital care, for the E/M of a patient including admission and discharge on the same date). However, if the patient's admission...

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