Ob-Gyn Coding Alert

Answer: The observation codes (99218-99220, Initial observation care, per day, for the evaluation and management of a patient ) are used per service date. So if the patient is admitted on day one and discharged on day two, you can bill both the admission and the discharge code (99217, Observation care discharge day management ).

But, if, for example, she was admitted at 11:30 p.m. on day one and discharged at 6:00 a.m. on day two, do not charge for both codes, because one half-hour of admission observation is too little time. In that case, you should bill an outpatient service for the half-hour on day one, and for the observation/discharge report (99234-99236, Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date ) for day two.