tci Medicare Compliance & Reimbursement - 2015 Issue 13

Reader Question: Put 99221/99211 Confusion Behind You With a Simple Query

Question: Our provider admitted a patient for observation, but documentation of initial admission had not been done. We are using office visit codes 99211-99215; however, the patient is seen the following two days in observation. Can we bill subsequent observation codes? Or does the follow-up observation need to be billed with office visits codes as well?  Answer: When the patient is in observation status and the documentation of admission cannot be confirmed, send a query to the facility asking for documentation of admission. If you receive inpatient documentation, then report the appropriate inpatient codes (99221-99223). Office visit codes...

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