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Sub care visit w/ prolonged svc or discharge mgt svc???

  1. Default Sub care visit w/ prolonged svc or discharge mgt svc???
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    Good afternoon,

    Would love some input on this scenario brought to me by our providers. If I spend an hour and half providing dischage mgt svc, I can only bill 99239: greater than 30 min. My collegue spends 40 min and gets reimbursed the same.

    Would it be approrpiatet for me to not bill discharge mgt svc and instead bill a sub care visit based on time and coordination of care with a prolonged svc code added on?

    What is the definition of coordination of care? Does it apply to inpt care only or can it apply to care we order for at home?

    Kudos for the providers thinking about reimbursement but ot sure it would be appropriate if the purpose of the visit os for discharge planning only?

    Any thoughts or reference I might look for?

    Thanks in advance,
    Mary Beth

  2. #2
    Just to clarify, are both providers billing discharges on the same patients?

    If the service you are providing is a discharge then that is what you need to bill. Only the provider that admitted the patient should be doing the actual discharge, unless they transferred care, and there is only 1 discharge per admit. So if they are just seeing the patient for the last time and signing off on the case then that would be a subsequent care visit and not a discharge.

    Laura, CPC, CPMA, CEMC

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