Wiki Who can use Observation codes??

[cvand1972]

Is it true that only the admitting physician can use the Observation code series 99234 - 99238?
For example, another Physician asks a Cardiologist to see a patient that is in observation status for Chest Pain. The Cardiologist is not the admitting physician. Since the Cardiologist is not the admitting physician and the patient is in observation status then the Cardiologist must use the code series for the Office or Other Outpatient series (99201-99205 or 99212-99215), correct??

 

[btadlock1]

Is it true that only the admitting physician can use the Observation code series 99234 - 99238?
For example, another Physician asks a Cardiologist to see a patient that is in observation status for Chest Pain. The Cardiologist is not the admitting physician. Since the Cardiologist is not the admitting physician and the patient is in observation status then the Cardiologist must use the code series for the Office or Other Outpatient series (99201-99205 or 99212-99215), correct??

Read the guidelines in green under "Initial Observation Care" - they direct you to use 99241-99245, or 99224-99226 as appropriate, for physicians who see the patient while in observation status, when they aren't the admitting physician. Hope that helps!

 

[RebeccaWoodward*]

FYI....Medicare doesn't follow CPT's guidelines.

Payment for an initial observation care code is for all the care rendered by the ordering physician on the date the patient's observation services began. 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.

For example, if an internist orders observation services and asks another physician to additionally evaluate the patient, only the internist may bill the initial observation care code. The other physician who evaluates the patient must bill the new or established office or other outpatient visit codes as appropriate.

Pg 52

http://www.cms.gov/manuals/downloads/clm104c12.pdf