Wiki Admit/Discharge Same Date - 2 physicians


Charm City - Baltimore
Best answers
Hi -

Hospitalist A admits a patient at 2 AM, documents and bills prior to going off shift at 7 AM. At 3 PM, Hospitalist B sees patient and decides to discharge patient. Hospitalist A is not present.

How should this be billed given the fact that "A" has already submitted and documented and initial inpatient admission and "B" dictated a discharge.

Hospitalists are of the same group/speciality.

Thank you. So, I have read the article and I have interpreted it that since they are the same group, no transfer of care is required and "A" can indeed bill for the admission and "B" can bill for the discharge service. I based this on the statement below from that article:

"When it comes to billing either 99238 or 99239, discharge services should be performed by either the attending physician of record or another physician within that same group. A physician outside your group may perform the discharge only if the patient's care has been transferred to that physician during the hospital stay"

This is a great article, but it doesn't really address your question.

If admit/discharge was done on the same calendar day (> 8 hours) you must bill codes from 99234-99236. Our policy is to give credit for the single code to the admitting physician, but you can't bill a separate admission and discharge on the same calendar day by physicians of the same specialty/group.

Your interpretation below does not apply if the admission is done on the same day. This instruction applies only to when the discharge is done on a subsequent day, because yes...the discharge must be done by the attending or someone from the attending's group.

This is going to be so painful! I have always thought that the use of Same Day Admit/Discharge was the way to go, but I kept getting told that this was impossible because "A" is not present and personally performing the discharge due to shift changes.

How would this work then when "A" is not personally doing the discharge? Novitas, our contractor has stated that the billing physician must be present and personally perform the services and that both the admission and discharge notes were done by that same billing physician.