nikki_coder
Networker
Is it appropriate to bill 99463 if the provider does the h&p and discharge on the same day but the baby was born the day prior to these services being done?
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Wiki 99463- it appropriate
- Thread starter nikki_coder
- Start date
jgf-CPC
Guest
99463 specifically states E&M of normal newborn infant admitted and discharged on the same date. When was the newborn actually admitted?
nikki_coder
Networker
Heres the scenerio--
Baby is delivered on 5/28/09 and discharged on 5/31/09. For some reason the h&p and discharge are both done on 5/31/09. The attendance at delivery was done on 5/28/09.
Baby is delivered on 5/28/09 and discharged on 5/31/09. For some reason the h&p and discharge are both done on 5/31/09. The attendance at delivery was done on 5/28/09.
FTessaBartels
Guest
Date of service
The date of service is the date the service was actually provided ... even if the documentation wasn't done for a couple of days.
So if the physician actually saw the infant on date of birth and admitted the child, but didn't do the H&P until two days later ... then the H&P should start with something like "Late entry for service provided on mm/dd/yy."
Or are you saying that no physician saw the infant until 5/31/09?
There is also the possiblity, of course, that the transcription service has the wrong date of service on the H&P (it happens) ...
F Tessa Bartels, CPC, CEMC
The date of service is the date the service was actually provided ... even if the documentation wasn't done for a couple of days.
So if the physician actually saw the infant on date of birth and admitted the child, but didn't do the H&P until two days later ... then the H&P should start with something like "Late entry for service provided on mm/dd/yy."
Or are you saying that no physician saw the infant until 5/31/09?
There is also the possiblity, of course, that the transcription service has the wrong date of service on the H&P (it happens) ...
F Tessa Bartels, CPC, CEMC
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nikki_coder
Networker
Most of the time our providers dont do the initial h&p the day of birth but rather one or two days after, and sometimes they will then discharge the baby later that same day. We were not sure if it would be appropriate to bill a 99463 (admit and discharge on same day) since the baby wasnt born the day of service being submitted but rather the h&p and discharge just happen to be provided on that day. Or would it be more appropriate to just bill 99460and 99238.
FTessaBartels
Guest
Doing H&P does NOT equal admitting
Doing the H&P is a paperwork administrative function required by the hospital. It does not equal admitting the patient, or providing the initial service to the patient.
That being said, if your doctors are FIRST laying eyes on the baby three days after birth, then WHO actually admitted the baby to the hospital?
But you also say "attendance at delivery was done 5-28-09."
I'm not sure I'm really understanding the scenario.
Physicians should document what they do, when they do it. And coders should code what was documented.
F Tessa Bartels, CPC, CEMC
Doing the H&P is a paperwork administrative function required by the hospital. It does not equal admitting the patient, or providing the initial service to the patient.
That being said, if your doctors are FIRST laying eyes on the baby three days after birth, then WHO actually admitted the baby to the hospital?
But you also say "attendance at delivery was done 5-28-09."
I'm not sure I'm really understanding the scenario.
Physicians should document what they do, when they do it. And coders should code what was documented.
F Tessa Bartels, CPC, CEMC
bdsteffens
Guest
Ok, here's my situation. The baby was born/admitted on 8/4/09. He was not seen for the newborn physical until the next day. After the physical, he was discharged.
I can't bill both 99460 & 99238 on the same day, and 99463 is for a 1 day stay. Do I bill only the 99460?
I can't bill both 99460 & 99238 on the same day, and 99463 is for a 1 day stay. Do I bill only the 99460?
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99463
We have read the AAP interpretation which appears to make sense but would like a definitive answer. The wording states admission and discharge the same day. Our providers state they are admitting and discharging the same day. They are doing and admission note and then a separate discharge note and using 99463. Isn't the wording open to interpretation and who makes the final decision as to accurate coding?
We have read the AAP interpretation which appears to make sense but would like a definitive answer. The wording states admission and discharge the same day. Our providers state they are admitting and discharging the same day. They are doing and admission note and then a separate discharge note and using 99463. Isn't the wording open to interpretation and who makes the final decision as to accurate coding?
I actually found an AAPC presentation along with an AAP article that states 99463 is for physician services and the admit is the physician's admission and discharge on the same day, not the hospital. We document both services an admission note and a discharge note on the same day and use 99463.
That is exactly what we are doing. Per the AAP and an AAPC tutorial the "admission and discharge" applies to the physcian services and not the hospital dates. Physicians who are doing both and no other doctor will be seeing them are providing more services than a 99460 so we are using 99463.