tci General Surgery Coding Alert - 2005 Issue 7

Reader Questions: Observation Status Is Outpatient

Question: When providing a consult for a patient admitted to observation, should we report the inpatient or outpatient consult codes? What if the patient is subsequently admitted to the hospital?Pennsylvania Subscriber Answer: You should consider patients admitted to observation status as outpatients for coding purposes. Therefore, if the surgeon provides a consult for a patient in observation, she should choose from among the office or other outpatient consultation codes (99241-99245) based on the E/M service level supported by documentation.Even if another physician subsequently admits the patient to the facility, if your surgeon provided the consult while the...

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