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Discharge/observation

Judy Posted Thu 19th of September, 2013 11:28:38 AM

Recently we have been denied the discharge summary '99217' on a patient in hospital observation and my physician initiated the observation services. Both patients have medicare insurance. A consultation was requested of a cardiologist who saw the patient each day and he billed a subsequent observation code on the same date the patient was discharged and my physician charged the '99217'. We have been denied our '99217'(discharge) on the same date the cardiologist charged the subsequent observation. The cardiologist also did a cardiolyte stress test on the discharge day on one patient and an ECHO on the other patient on the discharge day. Is the problem that the cardiologist should be charging outpatient codes like the office visit codes?

SuperCoder Answered Thu 19th of September, 2013 17:36:46 PM

Hi ,

My senior editor is working on this.

Thanks.

SuperCoder Answered Thu 19th of September, 2013 17:36:46 PM
With Leigh
SuperCoder Answered Thu 26th of September, 2013 17:13:38 PM

Because Medicare no longer recognizes the consultation codes, the physician who is consulting will have to use the regular clinic and other outpatient services E/M codes. Only one physician can be the ‘attending’ physician who orders and monitors the observation services. In a slightly different way this same issues occurs on the inpatient side. However, for the attending physician on the inpatient side we have the “-AI” modifier that separates the attending from any consulting physicians.

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