Wiki Observation billed on same day as inpatient room

[Willow123]

Hello: We received an inpatient claim with Bill Type 111 where the provider is billing for both the observation room rate on the same date as the inpatient room rate (Rev code 120). I'm trying to find Medicare guidelines that will state that both charges cannot be billed together on the same date.

Any recommendation?

 

[brownprofessionalcoding1]

Observation

Observation Care Codes may not be billed for hospital inpatients. The appropriate hospital visit codes should be used.

Medicare Claims Processing Manual: CMS Publication 100-04; Chapter 12, § 30.6.8 (D)

Does this help? brownprofessionalcoding1@yahoo.com