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Facility observation coding in ED- commercial payer

Hi all!

My boss says that code 99218 has to be added multiple times to get reimbursement (added once for every 30 min that the patient is observed) So let’s say the patient was observed for 6 hours, according to her it must be added 12x. Makes no sense to me. Shouldn’t the 99218 be coded just once in this case?

This is for facility coding. I have tried to show her the CPT description that says ‘per day’ but she says that’s for physician billing. Do you guys know of any guideline that I could show her in regards to this? PLEASE advise!! Thanks.

Medical Billing and Coding Forum