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tci ED Coding & Reimbursement Alert - 2014 Issue 6

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Want Audit Proof Claims? Review Medicare’s Requirements For Observation Care Because observation services are by definition outpatient services, you’ll need to ensure that claims show placement into observation was specifically ordered at a time when it was uncertain if an inpatient admission would be necessary.   Key: Hospitals will report the ED or clinic visit code or, if applicable, G0379 (Direct admission of patient for hospital observation) and G0378 (Hospital observation services, per hour)  and the number of units representing the hours (rounded to the nearest hour) spent in observation for all Medicare observation services, says...

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