Gastroenterology Coding Alert

Reader Question:

Distinguish Whether Observation Patients are Inpatient or Outpatient

Question: For all patients under observation admitted in our facility we have been using outpatient consult codes with POS 22 (outpatient). Recently, we were told that if the patient continues to remain under observation for another day, we should use a hospital visit code with POS 21 (inpatient). This is contradictory to how we have been reporting it as we continue to use POS 22. Please tell us what is appropriate?Texas SubscriberAnswer: For patients under observation, the appropriate outpatient consult code (99241-99244) with POS 22 (outpatient) is the right way to report for the first day. The reporting for observation on the subsequent day is in the same manner depending on the patient's condition as reported in the documentation provided by the doctor.If other physicians, other than the admitting physician, are checking the patient while under observation, you have to bill their services using appropriate outpatient consultation or service codes [...]
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