Author Topic: Confused about specialist billing for Observation patients  (Read 315 times)

keashdoc

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Confused about specialist billing for Observation patients
« 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

Michele

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Re: Confused about specialist billing for Observation patients
« Reply #1 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. 
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