tci ED Coding & Reimbursement Alert - 2016 Issue 9

Reader Question: Check Medical Necessity, Calendar for ED Observation Services that Transcend Midnight

Question: We have a patient that presented to the ED at 10 pm on day one and after examination and treatment began, the decision was made to admit that patient to observation status after midnight. Can we report and ED E/M service on day one and an observation service on day two for the same provider? Washington Subscriber Answer: CPT® states:  When "observation status" is initiated in the course of an encounter in another site of service (e.g., hospital emergency department, office, nursing facility) all evaluation and management services provided by the supervising physician or other qualified health...

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