Health Information Management

Tip: Proper use of new subsequent observation codes

APCs Insider, February 4, 2011

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

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.

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular