Medicare Claims Processing Manual, Chapter 4 (Outpatient) doesn't speak to surgery specifically, but does advise for both OBS and ER as follows:
Section 290.2.2
"If a period of observation spans more than 1 calendar day, all of the hours for the entire
period of observation must be included on a single line and the date of service for that
line is the date that observation care begins."
Section 180.6
"The line item date of service for the ER encounter is the date the patient entered
the ER even if the patients encounter spans multiple service dates"
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Sheila Goethel
Coding Services Senior Manager
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Original Message:
Sent: 12-03-2018 10:43
From: Nelda Laskey
Subject: DOS for Surgeries that begin one day and end the next
I agree with you Lawrence but also unable to find that "needle in the haystack". If anyone else has a definite answer, please post and thanks to everyone.
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Nelda Laskey RHIT
Coder/RAC Coordinator
Kearny County Hospital
Original Message:
Sent: 12-02-2018 08:42
From: Lawrence Barr
Subject: DOS for Surgeries that begin one day and end the next
Hello!
It is very frustrating that a direct answer to this question is so hard to find. I am sure it is somewhere in the CMS Medicare or UB instructions. However, finding the answer using a web search seems to be like finding a needle in a haystack.
I have always used the date the procedure begins. I have never been questioned using the beginning date even when the procedure spans two dates.
If someone can direct to an official source, it would be greatly appreciated.
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Lawrence Barr
President
Original Message:
Sent: 11-30-2018 09:31
From: Kavita Nagrani
Subject: DOS for Surgeries that begin one day and end the next
Hello
What is the correct DOS for a surgery that begins before midnight on 11/29 but ends at 1am on 11/30. I can't seem to find the guideline.
Thank you!
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Kavita Nagrani
Biller - CCS
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