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Discharge part of post op global?

  1. #1
    Location
    Greenville, NC
    Posts
    87
    Default Discharge part of post op global?
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    Patient is referred to general surgery (seen in office). Patient is diagnosed with colon cancer, is admitted as inpatient, undergoes colectomy by general surgeon, is followed post op, and discharged home. Is the discharge (99238) typically part of global, typically payer specific, or what? I would have thought the 99238 would have been paid, but payer is saying "A coding error was detected. Payment for this post op was included in the surgical." Any ideas?

    Thanks for any help.
    Hunter Smith, CPC

  2. #2
    Location
    Richardson, TX
    Posts
    822
    Default
    Yes, the discharge is normally included in the procedure. They look at it like this: you have to admit the patient for the procedure so discharge is part of it too; on the same day. Now, if they are discharged days after or event the next day, then yes, 99238 can be billed.
    Julie Graham, BA, CPC, CCC

  3. #3
    Location
    Milwaukee WI
    Posts
    4,466
    Default Post op care
    The payment for the procedure includes all post-op care (including discharge and office visits) for 90 days.

    Discharge is NOT separately billable.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  4. #4
    Location
    Greenville, NC
    Posts
    87
    Default Thanks
    Thanks very much for your help!

    Hunter Smith, CPC

  5. #5
    Location
    Traverse City, MI
    Posts
    33
    Default
    These 2 responses contradict each other. Julie & F Tessa, do either of you have documentation to support your statements? I am under the belief that the discharge is included only on the same date of a procedure. Thank you for clarifying this.

  6. #6
    Location
    Milwaukee WI
    Posts
    4,466
    Default Facility requirement vs billing
    Do not confuse a requirement from the facility for a discharge summary with whether you can separately bill for discharge day management.

    A hospital (or other facility) may have requirements for specific paperwork, including a dictated discharge summary. The physician must comply with those requirements if s/he expects to continue to have privileges at that facility.

    Regardless, if the procedure performed has a global period, AND the discharge falls during that global period, then the discharge (like any other E/M code) is considered part of routine post-operative care and is NOT separately billable.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  7. #7
    Location
    Traverse City, MI
    Posts
    33
    Default
    Thanks for the info! This has been a greatly debated issue.

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