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Orthopedic Coding Alert

Reader Questions:

How to Code Elective Surgery

Published on Sun Aug 01, 1999

Question: 1. When patients are admitted for elective surgery, is it proper to code with the observation code (99219)? 2. If treatment is emergent/non-elective, does this code apply?

Anonymous ME Subscriber

Answer: 1. CPT states about observation codes: These codes are not to be utilized for post-operative recovery if the procedure is considered part of the surgical package. Therefore, it would not be appropriate to bill for observation after the surgery is performed. 2. If during the observation stay, the decision for surgery is urgently made, then it would be appropriate to code from observation services (99218-99220) with the -57 modifier (decision for surgery) attached.
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