Medical Billing Forum

Billing => Billing => Topic started by: keashdoc on February 26, 2018, 05:54:52 AM

Title: Confused about specialist billing for Observation patients
Post by: keashdoc on February 26, 2018, 05:54:52 AM
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
Title: Re: Confused about specialist billing for Observation patients
Post by: Michele on February 26, 2018, 02:07:32 PM
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.