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Ob-Gyn Coding Alert

Reader Questions:

Observation Stay Consult? Choose 99241-99245

Published on Sat Aug 26, 2006

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

Wisconsin Subscriber Answer: Fight the temptation to report observation codes 99218-99220 (Initial observation care, per day, for the evaluation and management of a patient ...). 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 ...).
 
Note: If your ob-gyn admitted the patient to the hospital following the consultation, you may be able to make a case for reporting both services with some really good documentation. Many payers, however, will only allow the outpatient consultation. If this is the case, be sure you include all work on that date when selecting the consultation level.  -- The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC-OGS, MA, an ob-gyn coding expert based in Guadalupita, N.M.
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