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ED Coding and Reimbursement Alert

Reader Question:

Can you report an observation service if the patient is subsequently admitted?

Published on Wed Nov 21, 2012

Question: A 65-year-old patient with significant airflow limitation due to chronic bronchitis and emphysema is admitted to observation for acute bronchitis. The ED physician performs a comprehensive history and a comprehensive examination along with medical decision-making of high complexity, the ED physician decides to admit the patient to observation status. Initially, the saturation is satisfactory and the physician starts the patient on antibiotics and bronchodilators by inhalation. After spending 8 hours in observation from 10 AM to 6 PM, the patient's condition begins to deteriorate, the O2 saturation falls and the emergency physician decides the patient needs to be admitted to the hospital. The emergency physician contacts the patient's PMD for admission to the hospital. Is this an observation service?Kentucky SubscriberAnswer: On the claim, report 99236 (Observation or inpatient hospital care visit for the evaluation and management of a patient, including admission and discharge on the same date, which requires [...]
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