Physician office services same day as discharge?

[jfeight]

A hospital is discharging a patient; patient is to receive follow up skin substitute applications within a provider's office. patient lives three hours away, so they would like to have the patient go directly from discharge to the provider's office and have the skin substitute applied. Would the provider be paid for the product/application, or would the claim conflict with the discharge date? Additionally, would Medicare assume if the patient needed such a service so close to the inpatient stay, that it should have been provided while patient was in the facility? Any help is welcome--I'll post this on the physician forum as well.

 

[thomas7331]

If the provider's office is a separate private practice not owned or operated by the facility, then this should not be a problem and not create a reimbursement conflict with the discharge date of the hospital claim. The question of why this was not provided by the hospital prior to discharge is a legitimate one that could come up in the event of an audit, but as long as this is medically necessary and being done for a valid reason, then I imagine it would not be an issue.

 

[jfeight]

If the provider's office is a separate private practice not owned or operated by the facility, then this should not be a problem and not create a reimbursement conflict with the discharge date of the hospital claim. The question of why this was not provided by the hospital prior to discharge is a legitimate one that could come up in the event of an audit, but as long as this is medically necessary and being done for a valid reason, then I imagine it would not be an issue.

so helpful--thank you!

 

[janetwv]

Lipogem

Is anyone billing for Lipogem injection? What unlisted CPT code and what consist of the cost of procedure? thank you