tci General Surgery Coding Alert - 2022 Issue Q1

E/M: Avoid Observation Coding Pitfalls or Risk Denials

Remember Medicare vs. private-payer rules. Somewhere between inpatient and outpatient services lurks the mysterious observation evaluation and management (E/M) procedure codes. If you’ve ever felt confused by the observation coding rules and coverage ambiguities, we have some insights for you. Check out this quick review to make sure you file clean claims for your surgeons’ observation services. Meet the 3 Observation Requirements Before you turn to the observation E/M codes 99217-99226 (… observation care …), make sure you have documented these three components: The provider should clearly communicate in the chart that they are placing the patient...

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