Wiki 99236

[Shortcakecoder101]

Hi all, I have a question regarding an observation code. Our Dr. billed 99236, but she was not the admitting Dr. Would I bill a 99223 or an office visit code?

Thanks!

 

[haraml7]

Was the patient admitted and discharged on the same day? The CPT guidelines show us to use the 99223 if they were discharged on a different day of admission.

 

[AmandaBriggs]

Only the provider/group that initiates (orders) observation status for the patient may bill the observation codes. If your provider did not admit the patient to observation, then this provider must use the office or other outpatient services codes 99201-99205, 99211-99215. Here is from CMS:
Payment for an initial observation care code is for all the care rendered by the admitting physician on the date the patient was admitted to observation. All other physicians who see the patient while he or she is in observation must bill the office and other outpatient service codes or outpatient consultation codes as appropriate when they provide services to the patient.
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1466CP.pdf

Hope this helps!