Neurology & Pain Management Coding Alert

Question: When might our neurologist need to report observation care?

New Hampshire Subscriber

Answer: Several CPT codes apply to observation care, depending on the circumstances.
 
Report the appropriate choice from 99218-99220 (Initial observation care, per day, for the evaluation and management of a patient -) as the initial care code when your neurologist admits the patient to observation status. If the patient is admitted as an inpatient, your coding will depend on whether the admission takes place on the date of initial observation or on a subsequent date. If the patient is admitted later on the same date, select a code from 99221-99223 (Initial hospital care, per day, for the evaluation and management of a patient -). Choose the appropriate initial hospital care code (99221-99223) for admission on a later date. 

If your neurologist performs a consult while the patient is under observation, look to 99241-99245 (Office consultation for a new or established patient -). Although the descriptor states -office,- notes in this CPT section explain that you use these codes -- to report consultations provided in the physician's office or in an outpatient or other ambulatory facility, including hospital observation services --