tci Part B Insider - 2004 Issue 22

CORRECT CODING INITIATIVE: Observation Care Edit Causes Confusion

Coordination with inpatient departments on observation is important Of the thousands of new Correct Coding Initiative edits taking effect July 1, one edit is causing confusion and misunderstandings among payment experts. Starting next month, observation care codes 99217-99220 and 99234-99236 will become mutually exclusive with G0244 (Observation care provided by a facility to a patient with CHF, chest pain, or asthma, minimum eight hours, maximum 48 hours). This edit is confusing because G0244 is only billed on the facility side and used to capture the APC payments, says David McKenzie, director of reimbursement with American College of Emergency Physicians...

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