Results 1 to 3 of 3

Night resident note

  1. #1
    Default Night resident note
    Exam Training Packages
    Please help with this scenario as presented to me by a collegue:

    Night float resident sees the patient late evening and does an H&P for the admission, The teaching faculty physician receives sign out and sees the patient with his/her team of residents in the morning and decides that the patient is able to be discharged. Can the physician still bill a same day admit/discharge because they did review the findings and see the patient in the morning with the new team of residents and the physician did sign off on the resident's dictation of the H&P? Or can they only bill for the discharge because they didn't see the patient with the night float resident.

  2. #2
    Milwaukee WI
    Default Who is the payer?
    Who is the payer? This matters because Medicare (and other government payers) will not accept a counter signature from the teaching physician as adequate documentation of service provided, while most commercial payers allow this (supervision being by any means of modern communications, including available by phone).

    Let's assume this is a Medicare patient who is admitted by the resident in the evening on 4-1-11.

    Teaching physician has his initial hospital visit with the patient on morning of 4-2-11 and determins patient can be discharged. The TP's documentation (NOT the resident's) can be used to code 99234-99236 for services provided and documented on 4-2-11.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Default night resident note
    What you describe is what I came up with as well! Thanks for the response.

Similar Threads

  1. PA note vs. resident note
    By MADION in forum E/M
    Replies: 1
    Last Post: 05-27-2014, 10:10 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.