maryanneheath
Guru
Hello everyone,
I could really use some help with the following scenario....
A patient had an inpatient hospital stay, and was discharged the morning of 2-06-14. The patient presented to the emergency room a full twenty-four hours later, and was readmitted to the hospital on 2-07-14.
One of my colleagues feels that the physician performing the 2-07-14 admission History and Physical should bill the subsequent hospital care codes. She feels that the Medicare 3-day payment window applies to this case. I am not certain that this is the correct interpretation of the policy. I feel that the admission was a full twenty-four hours after the previous discharge, and the physician's services should be billed as initial hospital care.
My interpretation of the 3 day payment window policy is that it includes outpatient services prior to an inpatient and would not relate to a hospital admission. Of course, I could be completely off kilter here!
I hope this all makes sense. I would sure appreciate any guidance you could give me. Thanks in advance for your time!!!!
I could really use some help with the following scenario....
A patient had an inpatient hospital stay, and was discharged the morning of 2-06-14. The patient presented to the emergency room a full twenty-four hours later, and was readmitted to the hospital on 2-07-14.
One of my colleagues feels that the physician performing the 2-07-14 admission History and Physical should bill the subsequent hospital care codes. She feels that the Medicare 3-day payment window applies to this case. I am not certain that this is the correct interpretation of the policy. I feel that the admission was a full twenty-four hours after the previous discharge, and the physician's services should be billed as initial hospital care.
My interpretation of the 3 day payment window policy is that it includes outpatient services prior to an inpatient and would not relate to a hospital admission. Of course, I could be completely off kilter here!
I hope this all makes sense. I would sure appreciate any guidance you could give me. Thanks in advance for your time!!!!