joselian2008
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Hi, we do billing for a hospitalist group who is usually the main care provider for patients who are in observation status in a hospital setting. We bill all observation codes 99217-99220, 99224-99226, and 99234-99236. We have been getting some denials from Medicare with denial code 125. Called Medicare and they are stating that the observation claim is denied because they only allow ONE observation code per day. Unfortunately, when the patient is in observation status, other specialists also bill these codes. For example a cardiologist would bill a 99220 for observation care, and we also bill it for Internal Medicine. Although, it is a different specialty group, they are still denying it for only one obs code per day. We have done redeterminations with medical records and they are not working.
Has anyone else found a solution to this problem? Or experiencing the same?
Thanks.
Has anyone else found a solution to this problem? Or experiencing the same?
Thanks.