Oncology & Hematology Coding Alert

Question: How should I report observation care codes if my physician admits a patient for a 23-hour observation?

North Carolina Subscriber Answer: When the patient remains in observation for at least eight hours and the oncologist discharges the patient on the same calendar day, you may use codes 99234-99236 (Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date ...), which represent care lasting between eight and 23 hours on the same date.
 
Remember: You can't report any other E/M code when the oncologist discharges the patient on the same day that he admitted the patient to observation status.
 
But if the oncologist admits the patient to observation on one day and discharges the patient the next, you should assign 99218-99220 (Initial observation care, per day, for the evaluation and management of a patient ...) with discharge code 99217 (Observation care discharge day management [This code is to be utilized by the physician to report all services provided to a patient on discharge from -observation status- if the discharge is on other than the initial date of -observation status.- ...]).
 
Code 99217 includes all services provided on the date of discharge from -observation status,- which includes final examination of the patient, discussion of the hospital stay, discharge instructions, and preparation of discharge records.  -- The answers for You Be the Coder and Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and president of the American Academy of Professional Coders National Advisory Board.