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Wiki Inpatient to Swingbed on same day coding?

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cnramsey

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Priest River, ID
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I had a patient as a inpatient from 12/31/2009 to 1/05/2010 d/c at 0850.No documentation for d/c. Status changed to swingbed on 1/05/2010 at 0850. The Swingbed was from 1/05/2010 to 1/07/2010. Provider only saw the patient on 1/7/2010 and this was to d/c the patient. I sent a note to the provider stating he was missing his d/c note for the inpatient d/c. He states he doesn't need to do a d/c since the patient went to a swingbed. Is this correct?

This is what I have coded so far.
Inpatient 12/31-1/05/2010
12/31 99222
1/1 99232
1/2 99232
1/3 99232
1/4 99232
1/5 nothing
Swingbed 1/5-1/7/2010
1/7 99315

Thanks
Nichole
 
Hi Nichole,

When pts at our hospital are discharged from IP to Swingbed, the physician is required to complete a D/C summary because they are being transferred to a different type of care. We look at it almost as a different facility, even though they are in the same hospital. I believe they are billed separately too, so you would need a D/C summary as well as a H & P for the Swingbed admission. This is how we've always done it, and it makes sense to me. :)

Hope this helps!

Jennifer
 
We do it the same way as Jennifer mentioned. A discharge summary from the acute stay to swingbed needs to be done, which also counts as the H&P for the swingbed account, and then a swingbed discharge summary needs to be done when the patient is finally discharged to home (or wherever). They are 2 different charts for us here.
 
Hi again Nichole,

I just found some great info in a recent transmittal from CMS, it's transmittal 1875, December 4, 2009: Look in 30.6.8 in section A. It has a lot of info on Observation coding. It says that you must have a seperate chart for OBS and any other type of admit, and when I read it, I thought of you and your recent question. I also printed it out myself so I would have a copy close by because it is so informative. Hope it helps:)


http://www.cms.hhs.gov/transmittals/downloads/R1875CP.pdf
 
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