Wiki Obs new codes

[Sandra Fender]

I think I have my notes all messed up can anyone help so I can get this straight

I we were the admitting doctor we were using 99219, however medicare nor the advantage plans are no longer recognizing this code and acording to the update changes I am to use 99241-99245, and the sub visits 99224-99226 with modifer A1

If we are the consulting doctor durning this observation visit I use 99219, sub visits 99224-99226 with no modifer.

Only discharge is we admit which looks like it didn't change 99217.

 

[MCook]

It's the consult codes (99241-99245) that Medicare will not pay on. 99219 and other observation codes are allowed.

If you are the consulting doctor during observation, outpatient codes need to be used if the patient has Medicare. Only the doctor ordering the observation services can bill the observation codes. See the Medicare Claims Processing Manual - Chapter 12 Section 30.6.8 should answer your questions.