Brace For New Observation Codes

By Author: Angela Martin
Total Articles: 206
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If you have been on the look out for a code to reflect the evaluation and management service your urologist carries out during a subsequent visit with a patient in observation care, there's good news for you: CPT brings welcome relief in the form of 99224-99226. These codes are among a handful of new codes that could solve tough claims you may be facing now.


Gear up for new observation codes


One of the biggest changes for next year is that CPT adds to your E/M coding options with the introduction of three new observation codes, which are: 99224, 99225, 99226.


Prior to 2011, coding for the ‘middle days' of an observation service was a problem. Even though it's not the norm, there are situations where a patient is admitted to observation and remains in that status for three or more days.


When to use: If you had a patient admitted to observation on July 1 and discharged from observation on July 3, the problem for coders was how to bill for July 2. In the coming year, you will use 99224-99226 for July 2.


Disadvantage: You will ...
... not be elated when you hear the accepted payments for these codes. The RVU committee had compared new codes 99224-99226 for subsequent observation care to subsequent hospital care and had requested the same work value. However, the Center for Medicare disagreed with the proposal. In its place, to recognize the differences in patient acuity between the two settings, they removed the pre- and post services times from the values, reducing the values to 75 percent of the value for subsequent hospital care codes.


Sort through radiation implant changes


Among the list of brand new codes are radiation implant codes that you may use occasionally in your urology practice. They are 49327, 49412, and 49418.


Do not miss in-office radiological procedure changes


If your urology office performs in-office CT scans of the abdomen and pelvis at the same encounter will now be able to bill these two services with a single radiology code as opposed to having to code two radiology codes as you have before January 1, 2011.


The following codes should come in handy from January 1: 74176, 74177, 74178.


So if you want to be the first one to glean what else is potentially new when it comes to your urology coding, medical coding, sign up for an audio conference!