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Observation subsequent visit codes

Sandeep Posted Mon 15th of January, 2018 05:59:35 AM
In case of Medicare and Medicaid insurance, what should be observation (subsequent care) codes in E& M.( POS- Outpatient)
SuperCoder Answered Tue 16th of January, 2018 01:47:53 AM


As per CMS guidelines, Medicare do recognize 99224-99226 codes. As per guidelines, outpatient admitting/attending physician can bill initial and subsequent observation codes.  However, for the doctor who is not the admitter, they would need to code 99221-99215. Medicare only comes into play when a consult is request. Because Medicare does not recognize consult codes, you have to use an office visit code instead.


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