# discharged then readmitted same day



## jaldrich (May 22, 2009)

Patient was in hospital for 3 days for acute CVA. She was discharged to assisted living facility, at which point she fell. She returned to hospital 3 hours after discharged with a fractured hip. 

Can we bill and be paid for discharge and admission on the same date? She has Medicare as insurance. I was thinking that they were bundled into the highest subsequent that both notes would support, but then read somewhere that is not ok for Medicare. 
Suggestions? 
Thanks,
Jennifer, CPC


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## KeriH423 (May 26, 2009)

The fall with the resulting hip fx and readmission constitutes a separate presenting problem from the acute CVA of the initial hospitalization and should be billed and payable.  There should be separate claims created for each hospitalization documenting date, time of admission, etc.  The primary dx for the second hospitalization should be the hip fx, E codes, with mention of recent CVA after.


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## LTibbetts (May 27, 2009)

*discharge/re-admit*

What if the patient is readmitted later on the same day the he/she was discharged for the same complaint?


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## jaldrich (May 27, 2009)

Thank you KeriH for the reply. I have been struggling with this. 
Much appreciated. 
Jennifer


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## Karolina (May 28, 2009)

I agree with KeriH, because it is a new problem. I think if she were readmitted for the same issue, then the admission would continue.


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