tci Outpatient Facility Coding Alert - 2014 Issue 3

Patient Status: 3 Steps Show You When Facility's Overnight Patient Qualifies for Outpatient Coding

Not every outpatient passes through the freestanding or ASC facility. A patient staying overnight in the hospital can still be considered an “outpatient,” but the charge capture differs considerably from an inpatient. Factors such as using the same beds as inpatients can make coding and billing quite challenging for a patient undergoing observation care. Read on for three steps to consider before submitting codes such as G0379 (Direct admission of patient for hospital observation care) for a patient.   Step 1: Meet the Top 2 Conditions For Medicare patients, observation service falls under Part B coverage, while...

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