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How do we bill for these services?

  1. Default How do we bill for these services?
    Medical Coding Books
    We frequently end up caring for people who are ready to be discharged from an acute care setting (hospital) but are not ready to be going home due to

    a. social reasons

    b. insurance reasons


    How do we bill for these services?


    For example,


    An unfunded person ends up in End Stage Renal Disease. It takes about 2 months or more for Medicare to kick in. However due to lack of funding till then she cannot access any outpatient Hemodialysis units to consider discharging from the hospital. How do we bill for these days?


    Specifically

    a. how do we bill for days during which the person needs Hemodialysis (under usual circumstances this would be an outpatient event)? They would still be requiring oral medications almost always and parenteral route medications some of the times.


    b. how do we bill for days during which the person does not need Hemodialysis (under usual circumstances this would be outpatient home or care facility living)? They would still be requiring oral medications almost always and parenteral route medications some of the times.


    Please advise.


    Thanks!

  2. Default
    I'm sorry, but I have not worked with hemodialysis before, so I'm not going to attempt to address those situations for fear of telling you wrong information. However, we are running into the social situation with our hospitalist group and have been told by a consultant and auditing educator that this would be a charge that the hospital would basically have to "eat" because there is not medical necessity for the stay even though the hospital bylaws require that the hospitalist group sees these patients each day that they are occupying a hospital room.

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