tci E/M Coding Alert - 2014 Issue 3

You Be the Coder: Be Sure to Hit 8 With Observation Coding

Question: My physician saw a patient in observation status but discharged the patient before hitting the eight hour threshold. In the past, we have coded encounters like this with 99217, 99234, or 99235 but the claims were denied. How should we be coding?Ohio Subscriber Answer: When your physician sees a patient in observation status and discharges him before hitting the eight-hour threshold, you should report a code from the 99218-99220 range (Initial observation care, per day …),based on the level of service your physician documented. You wouldn’t use 99234 (Observation or inpatient hospital care, for...

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