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Cardiology Coding Alert

READER QUESTIONS:

Is Inpatient Code OK for Observation Patient?

Published on Sun Jul 26, 2009

Question:
When the cardiologist performs consult for a patient admitted to observation by another physician, I've been told to use a standard consultation code (99241-99244) and use POS 22 (outpatient). But I've also heard that for a visit the following day, when the patient is still in observation, I should use a daily hospital visit code (99231-99233) with POS 21 (inpatient). Is this correct? If not, which codes and POS should I use for the second day? Vermont Subscriber   Answer:
You are correct in using the outpatient codes and place of service (POS) on the first day. And you should do the same on the second day, reporting the appropriate outpatient visit code based on the cardiologist's documentation.   The Medicare Claims Processing Manual ( www.cms.hhs.gov/manuals/downloads/clm104c12.pdf ) explains that inpatient codes are not correct for patients in observation. Consider the following excerpts:   • "Payment for an initial observation care code is for all the [...]
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