Antepartum Inpatient Discharge & Readmission on same day

[Mely1697]

An ob patient was inpatient for hyperemesis for several days she was discharged and within a few hours she was readmitted. How would I bill for this? The same physician discharged her and readmitted her, also had dictated a discharge summary and a new H & P. Thanks

 

[Cmama12]

Commerical payer?

 

[Mely1697]

Commerical payer?

Yes, the patient has Aetna

 

[nielynco]

An ob patient was inpatient for hyperemesis for several days she was discharged and within a few hours she was readmitted. How would I bill for this? The same physician discharged her and readmitted her, also had dictated a discharge summary and a new H & P. Thanks

If the patient returned with the same condition, I recommend avoiding the discharge and admit codes. Instead, combine both levels of service in a subsequent visit code (99231-99233) based on the level of history, exam and medical decision-making. Do this even though he dictated a discharge summery and did a new H&P.

If the patient had an entirely new condition that caused the new admit, then follow through with a whole new H&P work-up and bill the initial hospital visit code (99221-99223), as well as for discharge services earlier that day. The payer probably will balk initially at seeing a discharge and an admit on the same day (and may even tell you to bill the hospital admit/discharge codes instead (99234-99236), but if you submit the appropriate documentation showing that the patient needed to be admitted for a new diagnosis, you should avoid being hassled (or denied).