Pulmonology Coding Alert

Question: I am not sure when to use observation care versus subsequent hospital care. Can you shed some light on which conditions may point to the need for one or the other? Minnesota Subscriber Answer: By definition, a physician admits someone to observation because she's trying to determine whether the patient's condition requires extended treatment in an inpatient setting. Use these two examples to help you choose an appropriate code: Example 1: A 68-year-old patient with bronchiectasis and a pleural effusion undergoes thoracentesis at the hospital. A few hours later, the patient is admitted to observation because a post-thoracentesis chest X-ray demonstrates a mild- to moderate-size pneumothorax. The pulmonologist performs a detailed history and a detailed examination along with straightforward medical decision making, then places the patient on mask oxygen therapy and schedules a repeat chest X-ray that night. On the claim, report 99218 (Initial observation care, per day, for [...]