tci ED Coding & Reimbursement Alert - 2017 Issue 2

Reader Question: Don't Self Bundle Procedures Associated With Observation Services

Question: I've been told that patients placed in observation and then receiving prior to or after the observation period a procedure (endoscopy, IR procedure, Cardiac Cath), the institution can only bill for one (observation or the procedure). My concern is that the patient will most likely be billed directly for the other portion. I would really appreciate if you can point me in the right direction to find out more information on this. New York Subscriber Answer: Using the Medicare rules the facility does submit a bill for all relevant procedures for observation patients. The Outpatient Code Editor then...

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