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Discharge Code for day of death? - patient and pronounce

randiroyder

randiroyder

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Lancaster, TX
How would you code an inpatient stay for a patient on their day of death. One of my doctors saw the patient and pronounce them dead and spoke to the family afterwards. Can you use a discharge code?
 
Hi Randi I do Hospitalist coding. We charge either 99238 or 99239 ( time must be documented) as a discharge for all paperwork and counseling involved. Only one MD can charge this code. Medicare has information regarding this in their E&M guide.
Lori-Hampton NH
 
This is also noted in the Principles of CPT 4th addition on Page 61 and 5th addition on page 66. You would chose the 99238 or 99239 depending on time spend as relayed by the ladies above. The Principles can be googled on-line if the books are not available to you. Peace and Many Blessings! -D
 
Hospital Discharge Management and Death Pronouncement Only the physician who personally performs the pronouncement of death shall bill for the face-to-face Hospital Discharge Day Management Service, CPT code 99238 or 99239. The date of the pronouncement shall reflect the calendar date of service on the day it was performed even if the paperwork is delayed to a subsequent date.

30.6.9.2 E


http://www.cms.hhs.gov/manuals/Downloads/clm104c12.pdf
 
USe can 99238 or 99239- make sure you use 2008 or 2009 CPT books

randi haight said:
How would you code an inpatient stay for a patient on their day of death. One of my doctors saw the patient and pronounce them dead and spoke to the family afterwards. Can you use a discharge code?
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Depending on the dates of service, make sure if pt expired after after 10/1/2008 use the new 2009 books for proper reimbursement and if before 10/1/2009 u use the 2008 CPT/ICD-9 coding books. This will affect the coding and reimbursement if proper coding books is not use as well.:cool:
 
cinnamon, please check your information. ICD9 code changes are effective Oct. 1, but CPT codes don't take effect until Jan. 1 of each year.
 
What if the Resident does the Pronouncement and the Attnding is on campus but bot having face to face contact, does this mean the Death Pronouncement cannot be billed at all?
 
Paperwork involved with death discharge

What paperwork is necessary for the doctor to bill the discharge for the pronouncing? I have an ER doctor that came up (patient was in a swing bed after being inpatient for surgery) and pronounced the patient...so the ER doctor can bill the discharge? The surgeon signed the death certificate with the dx for death...I am all confused. I believe I can bill the ER doctor for the discharge or a subsquent visit?
 
How to bill for death at home

What if the MD went to the patient home to do the death pronouncement. Has anyone billed for this? Would I use CPT 99339? Thanks!
 
mb12345 said:
What if the Resident does the Pronouncement and the Attnding is on campus but bot having face to face contact, does this mean the Death Pronouncement cannot be billed at all?
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I'm interested in this one too. I'm thinking that a discharge service cannot be billed, because "Only the physician who personally performs the pronouncement of death shall bill for the face-to-face hospital discharge day management service" (NHIC E/M Services Billing Guide, http://www.medicarenhic.com/ne_prov/publications.shtml) and inpatient services cannot be billed incident-to. It seems the only thing that might be billable is a subsequent care service if the attending documented seeing the patient and performing the service while the patient was still alive that day.
 
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Question/confused on CC on same day as Death Discharge

I code Hospitalists/Intensivist. I have not had this situation before, Intensivist sees patient and drops Critical Care 99291/40 minutes. Next he does Death Summary. I know I cannot code both on same date of service, but I am confused at to which one to code. I want to code the Death Discharge as it was the final information, but there is no time on it. Do I just automatically code 99238?

Thanks.
 
How would you code an inpatient stay for a patient on their day of death. One of my doctors saw the patient and pronounce them dead and spoke to the family afterwards. Can you use a discharge code?
 
Hospital Discharge Management and Death Pronouncement
  • Only the physician who personally performs the pronouncement of death shall bill for the face-to-face Hospital Discharge Day Management Service, CPT® code 99238 or 99239.
  • The date of the pronouncement shall reflect the calendar date of service on the day it was performed even if the paperwork is delayed to a subsequent date.
 
debbyallen said:
What modifier do I use for a patient that had a 99233 level of service and then died afterwards? Please help
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I do not believe a modifier is required in this situation. You would bill for the services rendered, 99233.
 
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