Billing > Billing
Confused about specialist billing for Observation patients
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keashdoc:
Hi,
I am really confused about how specialists are supposed to bill for Medicare Observation? I was using the observation codes (99218 -99220) for the initial specialist consultation visit and (99224 to 99226) for the subsequent consultation followup visits. However, the payments are a hit or miss so I am assuming I am doing something wrong. As a CONSULTANT am I supposed to bill the clinic visit codes (99201 - 99205) for the initial observation visit and (99211 to 99215) for the subsequent followup visits with a POS of 22? Any help would be truly appreciated.
K
Michele:
You would not bill 99201-99215 with a POS of 22. The purpose of the Observation codes 99218-99220 is to determine if the patient needs to be admitted, or if they can be discharged. I don't believe they are to be used to replace the consultation codes that are no longer covered. From my understanding specialists are supposed to use 99231-99233 inpatient visit codes.
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