Wiki Consultation on Observation Patient

[cwilson3333]

Patient in Observation Status for 23 hours
Dr. was requested to do Consult only
Looking at CPT Code 99243 [office/outpatient code]
Place of service: Outpatient Hospital [22]

The doctor then also saw the patient for a follow-up the next day before the 23 hours was up.

Looking at CPT Codes 99224-99226 for subsequent observation care.

Wrong or Right?

Thank you,
CW

 

[MaryKayDavid]

Obs consult

According to CMS

"only the physician admitting the pt to observation care status may bill these codes" including the admission (99218-99220), subsequent observation (99224-99226) and discharge from observation (99217) procedure codes. Anyone else seeing the pt while in observation care would bill using an office or other outpatient procedure code (99201-99215) as appropriate.

www.cms.gov/MLSMattersArticles/Downloads/MM7405.pdf.com

I hope that helped.

 

[sullivak]

For consulting physician-
I would code the 99243 (or 99203 if Medicare and if new to the Dr.) for the first visit and POS 22. I would code 99211-99215 with POS 22 for the following visit because if the patient is still in observation status at that time, it is still considered an outpatient visit. If the patient was admitted by the next visit, it would be coded in the 99231-3 range for subsequent inpatient care, POS 21.
Hope this helps!