Health Information Management

Tip: Proper use of new subsequent observation codes

APCs Insider, February 4, 2011

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The AMA added new CPT® codes 99224–99226 for subsequent hospital observation for 2011. These codes match subsequent hospital care codes already in use. The new codes are “per day” for reporting additional days of observation services; do not report them on the same day as initial observation care or discharge services.

The new subsequent observation codes are very similar to subsequent hospital care codes for inpatients. They include similar time designations, but the AMA developed new typical patient and service descriptions.

All levels of subsequent observation care include review of the medical record, results of diagnostic studies, and changes in patient status (e.g., changes in history, physical condition, and response to management).
Multiple physicians (e.g., attending physician, surgeon) may report these codes for E/M services provided to observation patients. Do not report these codes on the same day as:

  • An office visit
  • ED visit
  • Discharge from observation (code 99217)

This tip was adapted from “2011 CPT changes feature new time guidelines, subsequent observation care codes” in the February issue of Briefings on APCs.



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