The hospital must report the visit code with a modifier '-25' and the procedure code. Because of the description, it can only be reported once regardless of the number of fingers x-rayed. Because of the description, CPT 73660 can only be reported once regardless of the number of toes x-rayed. They will get paid, but modifier '-76' is required only on the second and third line. The global period includes the same day.
Observation is a major problem.
A. Yes, any service packaged or not, may be subject to review. If the observation services are not reasonable and necessary, they should still be denied. All claims will go through the OCE again after medical review. Denial of observation room charges will affect outlier and transitional corridor payments, as well as future APC rates. A. No, not at all.