Cardiology Coding Alert

Question: The physician admitted a patient to observation from the ED, but the patient signed herself out the next day against medical advice. A different physician dictated a discharge summary. Can we bill for this service?

Codify Subscriber

Answer: In this case, code 99217 (Observation care discharge day management [This code is to be utilized to report all services provided to a patient on discharge from "observation status" if the discharge is on other than the initial date of "observation status." To report services to a patient designated as "observation status" or "inpatient status" and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate]) might be an option.

When you can report 99217: However, it's important to note that to report 99217, documentation of face-to-face contact between the patient and the discharging physician is a crucial requirement. If the patient was discharged from observation status on a date other than the date of initial observation care, then yes, you can bill 99217.

According to CPT^® Assistant, 99217 includes the following services:

• Final examination of the patient
• Discussion of the hospital stay
• Instructions for continuing care
• Preparation of discharge records.

Caution: It's important to note that you should only report 99217 if the patient was discharged from observation status on a date other than the date of initial observation care.

Don't report 99217: But, if the physician never saw the patient and dictated the discharge just to fulfill a hospital requirement, do not report 99217.