Wiki Obs Status charges

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Twixle2002

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Hi We are recently getting denials from multiple insurances for billing 99201-99205 and 99211-99215 vs 99219-99217 and 99225. We are not the admitting physician. We are only consulting and following up for Cardiology. I have always billed E/M codes when we were not the admitting physician. It is my understanding that the obs codes are for the admitting physicians. Is anyone else having this issue?
 
You're correct that the OBS codes would only be for the admitting/attending provider. My only thought is that if it's a commercial insurance, they may still be looking for the consultation codes 99241-99245 in this place of service. The other office new and established codes were only moved into the observation setting when Medicare eliminated the consultation codes, so if an insurance didn't follow that change, they may not allow those codes in observation.
 
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