Wiki Discharge Summaries

[IABrat]

We are having physician arguements over discharge summaries lately. Can a provider use a discharge summary as an admission note when a patient is going from Observation to Inpatient or Inpatient to Swingbed? The providers have before but now some state new guidelines state it has to be two seperate dictations. I know we read in Coding Edge that a new exam and the reason for the change of status has to be documented but can this be done through the discharge summary. The providers want the answer in black and white. If anyone can help me I would really appreciate any insite or where I can find the answer in black and white.

Thanks for the help.

 

[ChrisZim]

IMO they have to write a new H&P, IF they want to pill a new patient admission code. I think they may have the option of sacrificing the additional $$ and billing a subsequent IP hosp charge if they don't want to dictate an updated H&P, but they definitely can't bill a 99217 (discharge from Obs) on the same day they admit the patient to IP @ the same hospital.

I think this might help - I use the Hospitalist site for many of my hospital coding questions. good luck to you.

http://www.the-hospitalist.org/details/article/747205/Observation_Care_.html