Results 1 to 7 of 7

Prolonged care/discharge same day

  1. #1
    Default Prolonged care/discharge same day
    Medical Coding Books
    I am new to pediatric hospital coding and need help. Newborn had seizures and physician did prolonged care, lumbar puncture and discharge to another facility with a NICU. I need help coding this discharge. I don't think I can use the hospital 9923?, and 99356 and a discharge code on the same day. Help please. Thank you in advance for any help you can give me.

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default Critical care?
    Without seeing all the notes ... I'm thinking that it's possible that you should be coding critical care 99291-92 for the care provided to this infant. The LP would be separately codeable, I believe.

    Read all the guidelines in CPT re critical care to be sure you have all the documentation you need.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. Default E&M, prolong and discharge same day same provider
    Provider has 99233 and prolong 120 minutes with statement "An additional 120 minutes was spent on face-to-face patient care beyond usual service with 120 minutes dedicated to counseling and coordination of care." Provider wants to bill 99356,99357x3. A separate discharge note stating greater than 30 minutes.
    After reviewing thread: Can the rounding 99233 and prolong be combined into critical care time and then bill discharge?

  4. #4
    Location
    Columbia, MO
    Posts
    13,122
    Default
    If you look in the code book you will under the 99356 the list of codes that prolonged time can be used with. this does include the 99233 however you do need total time spent with the patient and not just additional time. If you only have the 120 minutes documented then you will need to use that as the total time spent so you must back out the first 35 minutes for the 99233 to give you only 85 minutes of prolonged time. for a 99356 and a 99357 with 1 unit
    FYI even if after backing out the visit level if you were left with 120 minutes it would give you the 99356 and 2 units of the 99357 not 3 units. In addition the LP must not be included with in this time frame or the toime spent on the LP will need to be extracted out.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default Prolong visit and discharge
    Thank you for guidance with 99233 and prolong. Next question, is the provider able to bill all (visit+prolong) at discharge same day? Provider has separate notes for each.

  6. #6
    Location
    Columbia, MO
    Posts
    13,122
    Default
    Again look in your CPT book.. The 99356 can only be appended to the codes listed. This does not include the 99238-99239.

    Debra A. Mitchell, MSPH, CPC-H

  7. Default Thank you
    Quote Originally Posted by mitchellde View Post
    Again look in your CPT book.. The 99356 can only be appended to the codes listed. This does not include the 99238-99239.
    Thank you

Similar Threads

  1. discharge and transfer of care same day
    By avrilw in forum Billing/Reimbursement
    Replies: 2
    Last Post: 10-22-2014, 03:16 PM
  2. Subq and prolonged on discharge day
    By jnewberry in forum Internal Medicine
    Replies: 2
    Last Post: 05-11-2012, 10:09 AM
  3. Replies: 11
    Last Post: 02-21-2011, 12:06 PM
  4. Replies: 0
    Last Post: 02-03-2010, 03:58 PM
  5. Inpatient sub care and discharge day
    By dovejsd in forum E/M
    Replies: 2
    Last Post: 09-17-2008, 10:03 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?

Login

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.