A physician sees a patient in observation status and bills professional observation care. How should the E/M category be conceptualized for CCS-P?
Select an answer to reveal the explanation.
Short Explanation
Observation is a hospital-status story for the doctor’s professional visit codes—not ‘just another office appointment’ and not the facility’s APC pasted onto the physician claim. Pick the observation/hospital professional E/M family for initial or follow-up as documented.
Full Explanation
Professional observation care uses hospital observation (or current combined hospital inpatient/observation) E/M categories based on whether the service is initial or subsequent and on MDM or time. Office/outpatient codes are generally incorrect for patients in observation status when observation professional categories apply. Facility APCs belong on facility claims, and nursing facility codes are a different place-of-service category.