Wiki Episode of Care, initial hospitalization

[monicalwright@yahoo.com]

I work for a hospitalist group and my doctors are questioning the correct use of the episode of care for the initial hospitalization.

They are being told by the hospital that the entire hospitalization for the initial treatment of an injury is the initial episode of care. While I understand that this is appropriate for hospital billing, since the hospital submits one bill for the hospitalization, I am not sure it applies to the hospitalists.

The first time we see the patient in the hospital would be an initial encounter, but what about our follow up hospital visits, often after the patient has surgery? The patient is technically healing at these visits, but has not been released from the hospital. Would these visits be initial or subsequent?

Thanks,

Monica Wright, CPC

 

[mitchellde]

For the physician, after initial treatment of the injury has occurred and the injury is in a healing status, it will go to subsequent. Take for example a badly contaminated open wound that is not sutured due to high risk of infection, this will be treated daily to debridements and packing and antibiotics, this is all continuing active treatment so each visit is initial. However say a fracture that is treated in the OR and then has the pins, rods, cast, whatever the device is to hold it in the correct anatomic position, this then goes to subsequent for the next encounter.