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Ophthalmology and Optometry Coding Alert

Reader Questions:

Observation Status Is Outpatient

Published on Tue Mar 28, 2006

Question: When providing a consult for a patient admitted to observation, should we report the inpatient or outpatient consult codes? What if the patient is subsequently admitted to the hospital?


Pennsylvania Subscriber
Answer: Patients admitted to observation status are still considered outpatients for coding purposes. Therefore, if the ophthalmologist provides a consult for a patient in observation, she should choose from among the office or other outpatient consultation codes 99241-99245 (Office consultation for a new or established patient ...).

When another physician subsequently admits the patient to the facility, you should report an appropriate outpatient consult code if your ophthalmologist provided the consultation while the patient was still in observation.
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