Observation Care:
99224-99226 Are Intended for Treating Physician's Claims
Published on Fri Jan 14, 2011
Look to outpatient E/M codes if you don't meet this requirement.In effect for about a year now, CPT®'s subsequent observation care codes have been something of a mystery since they were released, but CMS finally ended that by issuing clarifications about how to report these codes.Pinpoint Services Included in 99224-99226The codes in focus are 99224-99226 (Subsequent observation care, per day, for the evaluation and management of a patient ...).CMS notes that subsequent observation care pay includes "all the care rendered by the treating physician on the day(s) other than the initial or discharge date," according to MLN Matters article MM7405, with an implementation date of Nov. 28, 2011.In addition to specifically referring to the "treating physician" in the above passage, the agency goes on to qualify that any other physicians evaluating or consulting on the observation care patient "must bill the appropriate outpatient service codes," and not the subsequent observation [...]