Coding, Classification and Reimbursement

Infusion Observation CAH question

  • 1.  Infusion Observation CAH question

    Posted 22 days ago
    First question:
    I was curious if you are billing one initial for the entire ER/OBS visit or if you are using an initial for every day?  I have seen others do this both ways and am curious which is the correct way.  Our ER/OBS are all on one claim since it is all outpatient hospital. 


    We are a Critical Access Hospital, this is my second question... 
    Patient came into ER, IV infusions were done and also a procedure. The patient was admitted to observation and IV meds/infusions continued.
    Normally for an outpatient surgery we do not capture any infusions/pushes for that stay as they are all related to the surgery. Should I leave off all the infusion charges as they continue in their Observation status onto the second day?  Or can I capture them for all the days except the first ER day when the procedure was done?

    Thanks for your help in advance!


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    Jeannette Walling
    RHIT, CCS
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  • 2.  RE: Infusion Observation CAH question

    Posted 21 days ago
    We bill one initial for the entire stay. I know insurance companies believe that it is supposed to be one per day but that is incorrect. I am also in a CAH.

    As for your second question I would charge for the pushes/infusions also but of course not during the surgery or post op period. You have to really look at the meds as to when they were given in order to charge for them. Once they are out of surgery and back to the floor if they are in OBS status I would charge for any meds during that period.

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    Beth Kosman, RHIT, CCS, CCS-P
    HIM Director
    Ringgold County Hospital
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  • 3.  RE: Infusion Observation CAH question

    Posted 21 days ago
    So if they came into ER and infusions/injections started and had surgery, then went OBS status, I would start capturing the infusions/injections at that point.  So would they be subsequent since the initial was given in ER even though we didn't bill for it?  Thanks!!

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    Jeannette Walling
    RHIT, CCS
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