# ob patient er visit vs observation



## czaniewski (Jun 25, 2009)

I need to know the correct procedures for sending an OB patient to the hospital for complications for observation and nst. Our physicians use the ER codes 99282 or 99283 for the visit. Is this correct procedure or should they be using hospital observation codes 99218,99219 or 99220 depending on how severe the complication is? When we get the progress notes from the hospital, the pt has been sent to the Labor and Delivery area for treatment; they do not remain in the ER. Most of the time the patients are there only for the day and are sent home.


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## kbarron (Jun 25, 2009)

Was the OB called into the ER as a consult?


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## Lisa Bledsoe (Jun 25, 2009)

czaniewski said:


> I need to know the correct procedures for sending an OB patient to the hospital for complications for observation and nst. Our physicians use the ER codes 99282 or 99283 for the visit. Is this correct procedure or should they be using hospital observation codes 99218,99219 or 99220 depending on how severe the complication is? When we get the progress notes from the hospital, the pt has been sent to the Labor and Delivery area for treatment; they do not remain in the ER. Most of the time the patients are there only for the day and are sent home.



I have my docs use 99234-99236 for these situations.  The patient must be admitted and discharged on the same *date*, otherwise use the observation codes you mentioned.


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## czaniewski (Jun 26, 2009)

kbarron said:


> Was the OB called into the ER as a consult?



note states physician admitted to labor and delivery triage


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## imjsanderson (Jun 30, 2009)

As long as the patient is there for over 8 hours it is observation admit/discharge same date.  If it is under 8 hours it would be 99212-99215 POS 22, along with the 59025.


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## msonger (Nov 5, 2009)

I had a CPC prep course teacher tell me that if it was more than 8 hours and pt was admit & d/c same use 99234-36 -- if less than 8 hours use 99218-20 if the patients status according to the hospital is OBServation.  Otherwise, if the pt is not admitted to OBS then you can only bill 99212-15.  I was told it is in the CMS guidelines.  Not sure where to look


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## msonger (Nov 5, 2009)

Also, we do not use ER codes unless pt was actually seen in the ER.  Only one physician/provider can bill ER code per day.  Any addtl physicians would either bill consults or 99201-99215 outpt codes unless admitted for OBS or Inpt stay


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