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Wiki Admit / Discharge Same Date of Service

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susanwarth

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Harrison, TN
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I would like to know if anyone else has ever come across this scenario - and been paid for it!

We discharge a patient from medical service and bill a 99238 with mod-25. Then we re-admit that patient on the same day to the rehab unit and bill an admit code with a different place of service.

We have several payors that will not pay us for the d/c.

Can anyone help me? I would appreciate it!!
 
When you say rehab, are you referring to a SNF? Are you using the Initial Nursing Facility Care codes (99304 - 99306)? It's been a long time since I've been involved in this scenario but that's what we did at a previous office I worked at, and as far as I know there were no problems. Then again, that was a while back...
 
You are allowed to bill a d/c from a hospital and an admit to a SNF on the same day. As far as to rehab, not really sure because I know we bill to some rehab centers that are still considered inpatent hospital and not SNF. Depends what the facility is considered I guess.
 
No - its not a SNF - It is only a rehab floor in the hospital for which one of my docs does admissions - they are being d/c from the regular floor to rehab and we aren't getting paid for both services even with a modifier.......

Just wanted to know if anyone experienced the same thing! Thanks for your help!
 
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