ACEP has a good resource on using observation codes (

You probably can't use the observation codes for boarding psychiatric patients since your have actually made a determination that they need inpatient psychiatric services. Observation codes are used when:

·         There is a lack of diagnosis certainty

·         Where therapeutic intensity may abate the patient’s need for inpatient admission

Some professional societies are looking at possible additions to the CPT© codes to be able to report these services.

As far as the post-op patients, the surgeons are responsible for their post-operative care as part of the post-service work so you couldn't report professional observation services for that group either.


Jeffrey Linzer Sr., MD, FAAP, FACEP
Associate Medical Director for Compliance
EPG/Division of Pediatric Emergency Medicine
Children’s Healthcare of Atlanta

[cid:[log in to unmask]]

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Brian Sanders
Sent: Wednesday, February 21, 2018 1:40 PM
To: [log in to unmask]
Subject: Observation question

Sorry to change to topic of the recent posts, but I have an observation billing question. We recently opened an observation unit in our Pedi ED and as everyone else, we continue to see a rise in pediatric psych volume. What is your experience in getting reimbursement for placing the pedi psych holds in observation while you are continuing to give ongoing care while they await bed placement?

Also, anyone admitting post surgical patients to their observation unit? i.e. appendicitis diagnosed in ED, to OR for surgery, then back to observation unit for their remaining care. (observation unit beds licensed as ED beds by DPH). Thanks for your input.

Brian Sanders, MD

Chief, Pediatric Emergency Medicine

MassGeneral Hospital for Children at North Shore Medical Center

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