tci Medicare Compliance & Reimbursement - 2009 Issue 6
OBSERVATION CODING: Observation Stays Are on the Rise -- 4 Tips Help Code Them
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Article Overview
This piece explains the scope of observation coding guidance in the context of rising observation stays and increased payer scrutiny. It is aimed at coders and billing staff working with hospital and professional claims, and it covers general reporting considerations for observation encounters, discharge billing, and the transition from observation to inpatient status.
Why This Topic Matters
Observation claims are closely reviewed, and errors can affect compliance and reimbursement. The article helps readers understand the broad areas of coding attention involved in these services.
Article Sections
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Billing considerations for observation encounters
Introduces the setting in which observation services are being used more frequently and why claims for these services are receiving greater attention.
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Office visit and observation reporting
Discusses how an initial office evaluation may relate to subsequent observation care and the general reporting issue involved.
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Same-day observation admission and discharge
Covers the general situation in which a patient is admitted to observation and discharged on the same date, along with the associated reporting topic.
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Subsequent-date discharge reporting
Addresses observation care that extends to a later date and the separate discharge reporting topic.
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Transition from observation to inpatient status
Notes the change in status from observation to inpatient care and the broader coding distinction involved.
What You Will Learn
- The overall purpose of observation coding guidance in the hospital setting.
- How observation encounters are discussed in relation to office-based evaluation and management services.
- How discharge reporting is treated when observation care spans more than one date.
- How a change from observation status to inpatient status affects reporting considerations.
Who Should Read This
- Medical coders
- Billing staff
- Hospital revenue cycle professionals
- Physician practice coders
- Compliance staff
Codes Discussed
Code Ranges Discussed
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