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Ask a Rev Cycle Expert: Reporting Observation Hours?


Could you please clarify how to bill observation hours? Are all of the observation hours listed on one line? What if we have more than 72 hours of observation?


According to the Medicare Claims Processing Manual, all hours for the period of observation should be submitted on a single line item, with the date of service as the date the observation services began. During the COVID-19 pandemic, the Medically Unlikely Edit (MUE) for HCPCS code G0378 Hospital observation service, per hour has been suspended. After the pandemic, claims with hours of observation over the MUE limit will need to be appealed with the documentation to support medical necessity.

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