Pulmonology Coding Alert

Question: A patient that I admitted to a skilled nursing facility in January passed away in June. The facility required that I, as the admitting physician, had to perform a discharge summary and sign the death certificate. How do I bill for this? Is there a specific discharge code to use?

South Dakota Subscriber

Answer: Section 50-19 of the Medicare Coverage Issues Manual states, According to established legal principles, an individual is not considered deceased until there has been official pronouncement of death. An individual is therefore considered to have expired as of the time he/she is pronounced dead by a person who is legally authorized to make such a pronouncement, usually a physician.

Reasonable and necessary medical services rendered up to and including pronouncement of death by a physician are covered diagnostic or therapeutic services. Therefore, performing a discharge summary following the patients death would not be billable, since Medicares billing guidelines only cover your services up to and including the pronouncement of death, but not following it.

Since the patient has passed away, she is no longer a beneficiary of the insurance, so any services provided after her death, including a discharge summary, will not be reimbursed.