# Admission for Observation care after PTCA/stent



## peeya (Jan 6, 2012)

Can I bill the Initial obervation care code (99234-99236) if the patient was scheduled for a heart cath that led to the patient having PTCA/stent. The patient needed to be kept in the hospital overnight for observation & then bill a discharge (99217) the next day?


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## Diane.Wilkins (Jan 7, 2012)

*OBSERVATION E/M codes*

The 99234-99236 codes are used when admitted and dismissed on the same date of service.  But for an OBS admission on day 1 with OBS dismissal on day 2, the 99218-99220 apply for day 1 of OBS and 99217 would apply for OBS date of dismissal.  Does this clarify a bit I hope?  If not, please write back and we will discuss further, thanks.


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## peeya (Jan 9, 2012)

Thanks for the correction in the CPT code. 

But my main concern is can we bill the Initial obervation care code (99218-99220) if the patient was scheduled for a heart cath that led to the patient having PTCA/stent. The patient needed to be kept in the hospital overnight for observation & then bill a discharge (99217) the next day?


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## ajs (Jan 9, 2012)

peeya said:


> Thanks for the correction in the CPT code.
> 
> But my main concern is can we bill the Initial obervation care code (99218-99220) if the patient was scheduled for a heart cath that led to the patient having PTCA/stent. The patient needed to be kept in the hospital overnight for observation & then bill a discharge (99217) the next day?



Yes, you can bill for the observation care provided the same day as the procedure.


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## theresa.dix@tennova.com (Jan 10, 2012)

ajs said:


> Yes, you can bill for the observation care provided the same day as the procedure.



Peeya,
99234-99236 are admit/discharge codes for the same day. This patient was not admitted and discharged the same day right? So no you cannot use this set of codes at all.

Now if this was a scheduled heart cath which led to the placement of a stent. The patient was seen in the office(since the cath was scheduled) and a H&P was done and billed. Then no you cannot bill an initial observation code(99218-99220) either. You can bill the discharge code 99217 the day after the heart cath/stent was done.

Hope this helps,Confusing I know.


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## peeya (Jan 10, 2012)

Thanks a ton..


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## crhunt78 (Jan 12, 2012)

I would use a 25 modifier on the observation code to show that it was separate from the procedure.


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