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Neurology & Pain Management Coding Alert

Reader Question:

Choose 99241-99245 for Observation Stay Consult

Published on Wed Jun 28, 2006

Question: How should I code a consult my physician performed for a patient admitted for an observation stay?

Wisconsin Subscriber Answer: Fight the temptation to report observation codes 99218-99220 (Initial observation care, per day ...). Payers consider a consult while the patient is in observation to be -outpatient,- so you should report 99241-99245 (Office consultation for a new or established patient ...).
 
If the patient is admitted, report the consult with an -inpatient- code (99251-99255, Initial inpatient consultation for a new or established patient ...).
 
Only one physician should report an observation admit code per observation stay.
 
Note: If your physician admitted the patient, you should report an admission code instead (99221-99223, Initial hospital care ...).
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