Wiki Discharge on different DOS

[SWall]

Hello,
I have an OB provider who billed 99238 on 10/30 but the patient was not discharged until 10/31 by another provider that is from a third-party company which I do not bill for. Would I bill the OB provider's DOS 10/30 as a subsequent inpatient visit?

 

[nielynco]

Hello,
I have an OB provider who billed 99238 on 10/30 but the patient was not discharged until 10/31 by another provider that is from a third-party company which I do not bill for. Would I bill the OB provider's DOS 10/30 as a subsequent inpatient visit?

The code was created to allow providers to bill for services on the actual date of discharge which normally involve work not usually performed during a follow-up hospital visit. That said, while CPT does not expressly say you can only bill for these services on the actual date of discharge, the intention was to do so. So, yes, I would convert the care given on 10/30 to a subsequent inpatient visit - the level is determined by the documentation. Also keep in mind that if the other provider is also billing for discharge, one of you would get a denial and since the other date is later, they will probably deny your charge.

 

[SWall]

The code was created to allow providers to bill for services on the actual date of discharge which normally involve work not usually performed during a follow-up hospital visit. That said, while CPT does not expressly say you can only bill for these services on the actual date of discharge, the intention was to do so. So, yes, I would convert the care given on 10/30 to a subsequent inpatient visit - the level is determined by the documentation. Also keep in mind that if the other provider is also billing for discharge, one of you would get a denial and since the other date is later, they will probably deny your charge.

Thank you. I was thinking that the 10/30 DOS would get denied. I appreciate your explanation.