tci ED Coding & Reimbursement Alert - 2003 Issue 1

Observation Codes:Details to Note

Reporting observation codes requires more than just designating the code. Watch out for the other factors influencing payment: The patient does not have to be in the hospital's designated observation unit to use "observation status" codes, says James Blakeman, senior vice president of Healthcare Business Resources in Bala Cynwyd, Pa. Time is not the key component of this E/M service, Blakeman states. Time matters only when you're deciding whether to use same-day observation codes for Medicare, in which case the physician must have provided observation care for at least eight hours on that date. The amount of hours after...

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