tci ED Coding & Reimbursement Alert - 2014 Issue 6

Reader Question: Observation Or Prolonged Care In The Urgent Care Setting?

Question: We do coding for an urgent care center within our facility and a question recently came up from the providers regarding patients who stay for “observation”. These providers are also work at one of our local hospital emergency departments and they asked about reporting observation codes in these cases. We have informed them that this would not be appropriate as we are not a hospital/facility setting. Would it be appropriate for them to report prolonged service codes in addition to the E/M code for these types of visits? If so, what type of documentation would they have...

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