Wiki Inpatient Leave of Absence

[jademound]

Patient has been at our facility for 6 weeks for IV medication and acute care of wounds. The patient has an appointment at an outside facility today. Patient will return to our facility this afternoon. How do we handle this? I know that we need to document the leave of absence as the outside facility will need that documented so they can bill for their service but I'm not sure how it should be documented. Does the patient get discharged and readmitted? Do we just note it in the record and make sure billing knows for the occurrence/condition code? If the patient is getting discharged from our facility tomorrow, would that affect how this is handled?

 

[kseebeck]

If the patient will be returning before midnight, there would be no lapse in the inpatient stay and would not be able to report Rev 018x. My experience has been to track the patient movement by discharging for the outside facility service and readmit when the patient returns; and submit one bill for initial admit date to when the patient is ultimately discharged.

Inpatient hospital example:
Mr. Smith admitted on 6/11/2021 has schedule services with outside facility on 7/23/2021 at 11:00am.
Mr. Smith was discharge at 10:00am to transport to facility and readmitted 2:30pm on 7/23/2021.
On 7/25/2021, Mr. Smith was discharge to SNF for continued care.
The inpatient claim would run from 6/11/2021 to 7/26/2021. The outside facility and transport company would bill the hospital who was paid for the inpatient stay for services rendered on 7/23/2021.

Your locate MAC, Noridian JF, is a great resource for billing. https://med.noridianmedicare.com/we...s-solutions/overlapping-claim-resolution-tips

In situations where the inpatient hospital does not have the technology to perform a procedure and transfers the patient for completion of the procedure, and the patient returns as inpatient, the outpatient hospital must look to the inpatient facility for payment under arrangement.