Clip and Save: Do Your Observation Services Pass the Tests?

Refer to this handy cheat sheet when ancillaries escape you

To justify separately reporting observation services with G0244 (Observation care provided by a facility to a patient with congestive heart failure, chest pain, or asthma, minimum eight hours, maximum 48 hours), you need documentation that the patient received certain tests correspondent with the condition. Here's what tests go with which ailment.
Congestive heart failure (CHF):
 
Chest x-ray (71010, 71020 or 71030)
 
Electrocardiogram (93005)
 
Pulse oximetry (94760, 94761 or 94762)

Chest pain:
 
At least two sets of cardiac enzymes - either two CPK (82550, 82552 or 82553) or two troponin (84484 or 84512)
 
Two sequential electrocardiograms (93005)

Asthma:
 
Peak expiratory flow rate (94010) OR pulse oximetry (94760, 94761 or 94762)
 
Tip: Remember that all the pulse oximetry codes aren't separately paid services - but you do still need to report and charge them separately in order to prove the medical necessity for observation for CHF and asthma patients.

 

- Published on 2004-11-22