Wiki discharge issues

[luvbuix]

i have several docs who are doing d/c summaries when the pt dies in the hosp & then not charging for them. to compound the matter some of these are shared visits. they will either do the note & then a "no charge" or they will let the APPs subseq visit note done that same day stand as the documentation along with the APPs charge for that day. i'm trying to tell them if they do the d/c they need to bill for it whether the pt died or was d/c'd alive. does anyone have any thoughts or resources on this matter??

 

[SDargaj]

Only the physician who personally performs the pronouncement of death shall bill for the face-to-face Hospital Discharge Day Management Service (99238 / 99239)....

So if the physician is not the one who actually declared the pt deceased, they should not be billing for a discharge.
Also, I am not sure if I am just not understanding your wording, but where you mention that they should be billing their d/c's regardless.....this is not the case. If the patient is already deceased, you should not be billing anything, as you would not be treating a deceased pt. That being said.....if the patient was seen PRIOR to passing, but the physician is NOT the one that pronounced the death, I would still bill for a subsequent visit

 

[luvbuix]

these are almost always our pts that are in the hospital under our service. our health systems have a policy that the admitting/attending needs to do the d/c note within 24 hrs of d/c. we have no issues doing the H&P on admission (initial hosp visit) or the d/c when the pt is still alive. it's only when the pt dies in the hosp that we have the billing issues.

 

[SDargaj]

these are almost always our pts that are in the hospital under our service. our health systems have a policy that the admitting/attending needs to do the d/c note within 24 hrs of d/c. we have no issues doing the H&P on admission (initial hosp visit) or the d/c when the pt is still alive. it's only when the pt dies in the hosp that we have the billing issues.

Are the physicians maybe not billing them because they aren't the one that pronounced the death?

 

[luvbuix]

no- these are pts that are on our service. we are the attending & do the initial visit which we bill for. same as if the pt is d/c'd to home (or wherever) alive. we are only having this issue when the pt dies. our health systems require a d/c note done within 24 hrs by the MD regardless of whether the pt died or was sent home.

 

[CBLENNIE]

our health systems require a d/c note done within 24 hrs by the MD regardless of whether the pt died or was sent home.

Is this really a documentation issue as required by your health system and not about submitting claims for the discharge service? I'm confused by you last post when compared to your original post.

i have several docs who are doing d/c summaries when the pt dies in the hosp & then not charging for them. to compound the matter some of these are shared visits. they will either do the note & then a "no charge" or they will let the APPs subseq visit note done that same day stand as the documentation along with the APPs charge for that day. i'm trying to tell them if they do the d/c they need to bill for it whether the pt died or was d/c'd alive. does anyone have any thoughts or resources on this matter??

Also, only 1 provider can bill for a discharge E&M per inpatient admission, is another provider billing the discharge E&M? Therefore, your doctors cannot bill it.

 

[luvbuix]

no- we are the admitting & the attending in these cases. all the other docs bill for the d/c whether the pt dies or not.

 

[CBLENNIE]

no- we are the admitting & the attending in these cases. all the other docs bill for the d/c whether the pt dies or not.

When you say the other docs bill for the d/c, are you referring to billing the actual dischargement E&M codes 99238 & 99239, or are you just trying to indicate that the other docs are billing an E&M?