Wiki Bcbs

[WBittinger]

I have been disputing with BCBS that Observation outpatient does not have to be authorized. They keep denying my appeals. Should there be an authorization required for outpatient observation? CPT code 99281-57

 

[JCaillouet]

Review the contract.

Also do you have the name of the reps which state 23 hour observation doesn't require precert? I hate to say it but if it's beyond 23 hours you'll need either an extended obs auth or see if it should be converted to inpatient.