Death pronouncement

[carol ann]

Emergency room doctor is called to pronounce patient. ER doc writes simpe note of patient death and releases body to funeral home. Patients regular doctor writes a discharge summary a week later, which recaps the patient stay and his demise. WHo gets to bill the discharge summary? The ER physcian who pronounced the patient or the doctor who completes all the paperwork?

[hewitt]

CPT Assistant states, "Can a physician bill for a hospital death summary if he or she is not present in the hospital at the time of the patient’s death? If yes, what would be the CPT code(s) to report?

Answer:

The hospital discharge services codes may be used to report discharge services to patients who die during the hospital stay. The attending physician may be needed to perform the final examination of the patient (to pronounce the patient’s death), discuss the hospital stay with family members or others, and prepare the discharge records (such as the discharge summary for the hospital record). However, if the physician is not the discharging physician, there is no CPT code for reviewing the patient’s medical record, selecting and preparing the death summary. The selection of the appropriate hospital discharge services code (99238 or 99239) is based on the unit/floor time, which includes establishing and/or reviewing the patient’s chart, examining the patient, writing notes and communicating with other professionals and the patient’s family. It is important to note, therefore, that there must be unit/floor time, ie, completion of forms/records in the medical records department or completion of a death certificate in the office is not reported as a discharge service"