Practice Management Alert

Question: Who can bill the 99238 discharge on a Medicare patient? Does it have to be the admitting physician only?

Georgia Subscriber

Answer: The attending physician of record is the only one who can report 99238 (Hospital discharge day management; 30 minutes or less), according to CMS. In the event that an internist or another physician performs the discharge, the same rule applies.

You still have some recourse, however. CMS offers some guidance when another physician or qualified nonphysician practitioner (NPP), such as a physician assistant or nurse practitioner, who has been managing other aspects of the patient's health not covered by the primary physician, discharges the patient. For those practitioners "who are not acting on behalf of the attending physician," you should bill a subsequent hospital care code (99231-99233, Subsequent hospital care, per day, for the evaluation and management of a patient ...) for the final visit.