tci Part B Insider - 2004 Issue 9

Part B Coading Coach: Keep An Eye On Observation Coding To Avoid Blurry E/M

Many coders have no trouble following CPT rules for hospital observation services, but they need to be familiar with the intricacies of both the CPT rules and Medicare's observation policy to get optimum benefits from observation care.   Since the inception of Medicare's observation coding policy, which conflicts with CPT guidelines, there has been some confusion regarding the appropriate way to bill for observation care. Reserve Observation Codes for Special Cases1. Typically, physicians use observation care codes for emergency department (ED) cases, particularly for situations involving trauma. Physicians often admit patients who have had traumatic accidents to observation status...

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