Corporate Compliance

Note: Carving out procedure time from observation hours

Medicare Insider, February 16, 2010

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Editor’s note: Debbie Mackaman, RHIA, CHCO, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor.

Facilities continue to work on developing efficient processes for carving out procedure time from billable observation hours. Some procedures are obvious and the documentation can clearly support this process. This includes services such as endoscopy, surgery, chemotherapy, and transfusions. In Chapter 4 of the Medicare Claims Processing Manual (Section 290.2.2), it states that "observation services should not be billed concurrently with diagnostic or therapeutic services for which active monitoring is a part of the procedure."

Continue reading Debbie Mackaman's note.



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