Consider Observation Codes for Patients In Apparent Limbo

Posted on 22. Mar, 2010 by Editor.

Medicare clears up confusion surrounding ‘8-hour rule.’

Reporting your FP’s observation services can be tricky business, as there is confusion about how, when, and why to choose from one observation code set or another.

Add to that a common misconception about Medicare coding, and you’ve got a recipe for potential disaster. Clear things up with this observation FAQ.

When Should I Use 99218-99220?

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Hurricane Ike Baby Boom Challenge: 99238 & 99239

Posted on 10. Jun, 2009 by .

Pediatric coders from Houston, Louisville, or anywhere else Hurricane Ike wrecked havoc 9 months ago: Get ready for a storm surge of new pediatric patients and neonatal coding challenges.

Ob-gyn practices are steeling themselves for a 25% increase in deliveries from mid-June to mid July, reports The Houston Chronicle. Why? You do the math. It’s nine months after weeks-long power outages left people with nothing to do but make new pediatric patients.

So, let’s all take a newborn coding challenge to show our solidarity with the coders and billers left in Ike’s path.

Question: Sometimes our pediatricians tell a new mom she can take her baby home the next day provided the newborn continues to stool and feed normally, and to have normal vital signs. The patient is then discharged from the hospital the next day without the physician seeing the patient.

Our hospital compliance plan calls for using CMS guidelines across the board. Should I charge the discharge on the hospital discharge day or on the last day the physician saw the patient?

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Capture ‘Patient Limbo’ Period With These Observation Coding Steps

Posted on 10. Mar, 2009 by .

Internist deciding on admission? That’s your signal to look at observation family.

You can quickly pin down which observation code (99218-99220 or 99234-99236) pair to use, and whether to add a discharge code (99217), if you zoom in on the stay’s date(s) and length.

Ensure your observation claims are 100 percent accurate simply by following this 5-step plan.

Step 1: Confirm Observation Service

Before coding, be sure that the service qualifies as an observation, confirms Carol Pohlig, BSN, RN, CPC, ACS, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.

Don’t miss our Internal Medicine Specialty Coding Conference July 9-11 in Orlando.

Observation is a hospital-based outpatient service used to determine if a patient needs inpatient care. So when you’re reviewing the notes, ensure claim correctness by checking the encounter specifics against this observation definition.

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5 Steps Ensure Correct Observation Care Coding

Posted on 27. Feb, 2009 by .

To prevent ED denials, code service only when doc makes admission decision.

Although CPT offers two observation code sets, and encounters that look like observations may actually be other E/M services, your observation coding can be spot-on every time simply by following this five-step plan.

Step 1: Confirm Type of E/M Service

Before coding, be sure that the service qualifies as an observation. “Observation is a hospital-based outpatient service used to determine if a patient needs inpatient care. Most payers limit the time a patient may be in observation status to 23 hours, though some (Georgia Medicaid, for example) allow as long as 48 hours,” explains Jeffrey Linzer Sr., MD, FAAP, FACEP, associate medical director for compliance at Emergency Pediatric Group Children’s Healthcare of Atlanta at Egleston.

One code or two for observation? Kenneth Engel shows you how to decide.

So when you’re reviewing the notes, ensure claim correctness by checking the encounter specifics against Linzer’s observation definition.

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