Tip: Billing for injections and infusions using condition code 44

Q. My understanding of the condition code 44 process is that we technically don’t have an order for observation until the actual observation order written. Does this mean that we may not charge for all the infusions and injections administered while the patient’s status was incorrectly inpatient? 
 
A.  No. My understanding is as follows. When you are able to successfully change the patient's status from inpatient to outpatient, using condition code 44, services provided in the inpatient setting are covered and payable on the same terms and conditions as if they had been provided in the outpatient setting. Because the hospital did not meet the observation order requirement, however, it may not convert that period of inpatient care to observation. Therefore, there should be no separate line item reported on the subsequent outpatient claim for observation services. All of the ancillary services, however, would generally be billable, subject to outpatient coverage and payment provisions.