Wiki Observation Coding

[pattivest]

We have a patient that has been in observation status for a number of days (about 15). The patient does not meet inpatient criteria and therefore must be billed as observation. This patient also has Pennsylvania Medical Assistance. Here is my question. I know that I can code for 99218-99220 for the initial day of observation. I also know that I can code 99217 for the date of discharge. How would everyone recommend I code for all the days in between. I was thinking of using the Established Patient codes 99212-99215. Also as a side note if anyone from Pennsylvania would like to recommend the best place of service code to use, our billing department is thinking of use a place of service code of 99 to bill this. Your help would be greatly appreciated.

 

[cheermom68]

observation coding

The subsequent days in between the admit and discharge have to be billed using the established patient office visit codes 99211-99215. But remember the documentation and medical necessity must be there to support the visit level.
Hope that helps.