99238 Coding for discharge after procedure

Tammy Hale

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Hello. I am new to hospital coding. Can someone please tell me if we can code a discharge 99238/99239 after a patient had surgery? The confusion seems to be is this considered part of subsequent visit during global or is Discharge exempt from global. I have spent quite a bit of time on line trying to find the answer and have had conflicting answers.

If we can bill do we need to add a 24 modifier to it if in global?

Thank you so much!

Tammy

Also I would need documentation to support if we can bill. I went to CMS but again could not find my answer there.
 
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It's global

Discharge, like all other E/M services, fall into the global period.

The only time you'd be able to code it is if (God forbid) the patient remained hospitalized and in your care beyond the global period ... but I'm guessing if that happened, the surgeon would transfer care to a hospitalist, so the surgeon wouldn't be doing the discharge in any case.

F Tessa Bartels, CPC, CPC-E/M
 

bran1120

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The only other scenario that you can charge a separate E/M within a global period is if the patient is being seen for a separate problem. For example, a patient in a global period for his appendix is then in a car accident and your physician (or another physician in your same group of the same specialty) sees the patient for the injuries related to the MVC. In this case you would bill the appropriate E/M services w/mod 24. This scenario actually happened with two docs in our group.

Brandy Allen, CPC
Practice Manager
 
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