• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

Discharge & Readmission same DOS

Erica1217

Guest
Messages
108
Location
Chicopee, MA
Best answers
0
How do you bill if the same doctor or group discharged a patient in the morning and then readmitted later, same DOS, same diagnoses?

I know Medicare and most payors would deny this since they are bundled w/ and indicator of 0.

Do you just bill a new admit only and combine the documentation for a possible higher level of service?

I know you can do this w/ regular rounds if the same doc or docs in the same group/same specialty see the same pt on same DOS.. just not sure if it would apply in this situation.

I can't find any guidelines regarding this particular scenario.

Thanks!

:) Erica
 

Jagadish

Guru
Messages
155
Best answers
0
Interdepartmental transfers or readmits will be paid if coded with subsequent hospital care codes (99231-233). This is what I observed from a Payor. I am not sure if it can be applied to all.
 

Erica1217

Guest
Messages
108
Location
Chicopee, MA
Best answers
0
Not for Medicare. :( I still can't find a definitive answer on this... I've posted all over the place and got 4 different answers....

Thanks,
:) Erica
 

Jagadish

Guru
Messages
155
Best answers
0
Erica:

Please check the follwoing:

http://www.cms.hhs.gov/Transmittals/Downloads/R1465CP.pdf


E. Physician Services Involving Transfer From One Hospital to Another; Transfer Within Facility to Prospective Payment System (PPS) Exempt Unit of Hospital; Transfer From One Facility to Another Separate Entity Under Same Ownership and/or Part of Same Complex; or Transfer From One Department to Another Within Single Facility
Physicians may bill both the hospital discharge management code and an initial hospital care code when the discharge and admission do not occur on the same day if the transfer is between:
• Different hospitals;
• Different facilities under common ownership which do not have merged records; or
• Between the acute care hospital and a PPS exempt unit within the same hospital when there are no merged records.
In all other transfer circumstances, the physician should bill only the appropriate level of subsequent hospital care for the date of transfer.
 
Messages
9
Location
Hanover Twp, PA
Best answers
0
admit and discharge to a different facility on the same day

Does any one know what should be billed if the same physician admits and pt and on the same day discharges the pt to a different facility? Thanks
 

greeneyz

New
Messages
1
Best answers
0
admit/discharge same day

I'm looking at observation admit/discharge same date codes 99234-99236.
 
Top