tci Outpatient Facility Coding Alert - 2015 Issue 3

Reader's Question: A Query to the Facility Can Get the Required Documentation

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 that need to be billed with office visits codes as well? The visits are not meeting the “3 out of 3” requirement. So we are billing office visits for the actual admission....which came from the direction of another coder. Then we are billing 99224-99226 for the following dates. South Dakota Subscriber Answer: When the...

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