Wiki Medicare Repeat Admissions


Hanson, MA
Best answers
For the scenario below, would you combine these accounts and add a B4 or RL condition code?

Patient discharged on 4/4/16 17:47, patient later presents to the ER and is seen by the ER physician on 4/4/16 22:16 but a physician order to admit the patient as an inpatient is not completed until 4/5/16 1:14

CMS IOM Medicare Claims Processing Manual - Chapter 3 - Section 40.2.5 - Repeat Admissions When a patient is discharged/transferred from an acute care Prospective Payment System (PPS) hospital, and is readmitted to the same acute care PPS hospital on the same day for symptoms related to, or for evaluation and management of, the prior stay’s medical condition, hospitals shall adjust the original claim generated by the original stay by combining the original and subsequent stay onto a single claim.