Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

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.
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.
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.

Related Topics