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Unsure if this death summary is billable??

  1. #1
    Default Unsure if this death summary is billable??
    Medical Coding Books
    Good morning all!

    I have read about that the physician must have face-to-face in order to be able to bill out a discharge summary for a pt who died in the hospital.

    However, how would this situation be handled?? The physician saw the patient on 3/22 at 11:30 (am/pm not given) and noted the patient was somewhat unresponsive and only recommended comfort measures. At 11:51 pm the same date, the resident came and saw the patient and pronounced the patient.

    Is this a billable discharge??? I am thinking no, even though the doctor did see the patient the same date, but not with the resident. Is this correct?



  2. #2
    Medicare Claims Processing Manual Chapter 12, E:
    Only the physician who personally performs the pronouncement of death shall bill for the face-to-face Hospital Dischage Day Management Service, CPT code 99238 or 99239.
    Incident-to is not applicable in the hospital setting so you would bill only for the services he performed, i.e. subsequent hospital visit.
    Also, in the hospital setting, time is documented as military time (up to 2400 hrs), so it was most likely 11: am however you will want to verify that this is how time is documented in your facility.
    adrianne, cpc

  3. #3
    Thanks Adrianne for your help! It is much appreciated!

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