Question: We kept a patient in the hospital overnight for observation and decided the next morning that surgery was not necessary. Should I report 9923x and discharge code 99217, even though within the hospital this stay remains outpatient? Answer: If a patient stays overnight (past midnight) in observation, you cannot report same-date observation/hospital admission and discharge codes 99234-99236. Instead, you must report the appropriate code for "hospital observation, initial observation care" from the 99218-99220 range on the day the patient was admitted. You would also report 99217 (Observation care discharge day management) on the day the patient is discharged, as you suspected.
North Dakota Subscriber
Tip: You should only report 99234-99236 when the physician admits and discharges a patient on the same day (which includes those who undergo a complete workup and then expire). As soon as you realize that code choice is based on calendar day and not on a 23-hour time period, you'll overcome the urge to report those codes.