# Emergency visit plus observation



## ytnobile@lexhealth.org (Oct 13, 2010)

What has been your experience with billing both ER visit then observation code on the same date, plus what is Medicare guidelines state? Thank you


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## Nandhakumar007 (Oct 14, 2010)

Hi...

Can pls send some scenario regarding Er and Obs code..

Thanks in advance


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## jimbo1231 (Oct 18, 2010)

*One scenario (maybe)*

The only scenario I can think of is that the patient comes to the ED on a given calendar date say 12/1. They are in the ED until 12/2 when they are admittted to Observation. CPT states that " Emergency Department.....are considered part of Observation Care when performed on the same date". So in the above scenario, on two separate calendar dates, you could code both. But getting paid without solid documentation to back it up could be another story.

Jim


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## Nandhakumar007 (Oct 19, 2010)

Hi..

The patient came to Ed on 12/1 and stayed in observation unit on 12/1 and discharged on 12/2 then we will be coding it as 99220-99218 for 12/1 dos and 99217 for 12/2 dos.

If the patient came to ED on  12/1 and stayed on observation unit on 12/2 and discharged on 12/2 then we have to code appropriate ed level for 12/1 and for 12/2 if it qualify for 8 hours then we have to code same day observation code.


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