tci ED Coding & Reimbursement Alert - 2015 Issue 9

Observation Codes: Look Through Observation Transparency Concerns To Be Sure You Select The Correct Code

Review these code descriptors to avoid compliance problems under close scrutiny When is the last time you carefully read the CPT® preamble language and the code descriptors for observation services? Observation services continue to be closely watched as Congress considers a bill for greater transparency regarding when and why observation services are reported rather than an inpatient admission. Several factors are involved in the controversy, which is mostly driven by changes in out of pocket payments by Medicare beneficiaries when they are observation patients. This is predominately seen when beneficiaries end up with huge bills when they go to...

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