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Observation CPT codes

Ashley Posted Mon 08th of August, 2011 17:34:19 PM

Can any physician who sees a patient in observation bill one of the observation CPT codes (99218-99220 OR 99224-99226) or can only the admitting physician bill the observation codes? Thanks!

SuperCoder Answered Mon 08th of August, 2011 19:14:04 PM

The attending of record writes the orders to admit the patient to observation; indicates the reason for the stay; outlines the plan of care; and manages the patient during the stay. The attending reports the initial patient encounter with the most appropriate initial observation-care code, and documents it appropriately.
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While other physicians (e.g., specialists) might be involved in the patient’s care, only the attending physician reports codes 99218-99220. Specialists typically are called to an OBS case for their opinion or advice but do not function as the attending of record.
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Billing for the specialist (consultation) service depends upon the payor.

Ashley Posted Thu 25th of August, 2011 15:54:33 PM

Thanks for the info Sanjit. Just so I understand this correctly, the admitting physician is the only physician who can bill 99218-99220 but the other physicians who are "consulted" to see the patient in observation can bill 99224-99226. Is this correct?
Also, I thought I read somewhere where the non-admitting physician can bill a new/established patient office visit (99201-99025 OR 99212-99215) if they see a patient in observation. Is this correct?
Thanks again for your help!

SuperCoder Answered Thu 25th of August, 2011 17:17:09 PM

You are right.

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