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Thread: Hospital Discharge

  1. #1

    Default Hospital Discharge

    AAPC: Back to School
    My general surgeon discharged a patient from the hospital,but I have also ran across another discharge by the PCP. In addition, the patient was admitted by the General Surgeon group. By the way the patient has a Medicare replacemene policy. Who should get reimbursed for the diacharge?

    Any insight would be great.
    Sonja Little, CPC

  2. #2
    Join Date
    Apr 2007


    Did your provider group perform any surgeries while the patient was in the hospital?
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

  3. #3


    If your doctor did the admit and assuming there were no surgeries done, and your dr did the discharge, your dr should bill for the discharge planning, if he did the discharge planning and get paid.

  4. #4
    Join Date
    Apr 2007
    Concord, NC or Rochester, NY


    the bigger question is who was following the patient in the hospital. If your group continued following and did not turn the patient over to the PCP, then your group should get paid for the discharge. That being said, the first one to bill Medicare will be paid and then there will be a fight to get it corrected. The PCP will have logic for why they should get paid, etc. - good luck

  5. #5


    All of the physicians can perform a discharge exam and get paid for it. Speciality physicians do it all the time. The discharge code is not for just one physician, it is for all the physicians in different groups that have seen the patient. For example, a pulmonary physician can bill a d/c code, cardiology physician, hospitalist, etc. The documentation must specify that it is a d/c exam and if the physician puts that he spent over 30 minutes the code can be upped to a 99239. If no mention of time then it should be a 99238. D/C codes are not just limitedfor use by the admitting physician. Any provider within a speciality that consults a patient while in the hospital can bill a d/c code if documentation is correct.
    Last edited by GaPeach77; 11-18-2011 at 07:55 AM.

  6. #6


    Thanks for the insighton this issue. I am new to billing for hospital rounds and it was very helpful. Provided a great deal of info I did not know.
    Sonja Little, CPC

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