Wiki Observation coding

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umcanes4

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Good afternoon!!!

I wanted to see if we can get some clarification on something. Let's say we have a patient in observation status..

admitting dr sees pt- bills 99218-99220
cardiologist is consulted and he sees pt- bills 99241-99245 or 99201-99205

when the cardiologist comes to do subsequent visits would they use codes 99212-99215 or 99224-99226?

Thank you in advance for the help :)
 
I believe, since the cardiologist needs to bill 9921x they would stay with that for a second visit. It is my understanding that Obs codes are only billed by the provider who ordered the observation.
 
dferree37 said:
I believe, since the cardiologist needs to bill 9921x they would stay with that for a second visit. It is my understanding that Obs codes are only billed by the provider who ordered the observation.
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That's correct, per my understanding also, and per CMS publications MM6740 and CR7405, only the admitting physician will be the observation codes, and any "all other physicians who furnish consultations or additional evaluations or services while the patient is receiving hospital outpatient observation services must bill the appropriate outpatient service codes."
 
Per the CPT book "The following codes are used to report the encounter(s) by the supervising physician or other qualified health care professional with the patient when designated as "observation status"

"For observation encounters by other physicians, see office or other outpatient consultation codes (99241-99245) or subsequent observation care codes (99224-99226) as appropriate".
 
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