# Admit/Discharge on Same Date - or Transfer To Another Unit



## ABridgman (Aug 30, 2013)

I have a situation I have not run across before...

The doctor has discharged a patient from one area of the hospital, say the ICU...and then admitted them into another unit of the hospital.

Doctor believes he should be paid for a discharge and an admit on the same day.

I am not sure this can be done, by Medicare rules, since the same physicians is performing both the discharge from one unit and then admit to other - i.e cannot bill 99223 and 99239 on same date...i.e. cannot bill 99239 (discharge from one unit) and the 99223 (admit to different unit) on same day.


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## ECOUSIN (Aug 30, 2013)

Patient's admitted and discharged on the same day should be reported with codes 99234-99236.


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## ABridgman (Aug 30, 2013)

OK...

So...if a patient is admitted on say Sept 1...then is seen on 9/2 - then is discharged from one unit of the hospital on 9/3 and admitted to another on same day, then is followed up on 9/4 and 9/5 then finally dischared on 9/6 I would bill this:

9/1 99223
9/2 99233
9/3 99236 (one line item only)
9/4 99233
9/5 99233
9/6 99239

Is that right?  it sounds like this would be right in this case.

In another case, say the patient is admitted and discharged on same day, say 8/26
I bill one claim line on 8/26 - 99236 - right?


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## dclark7 (Sep 3, 2013)

Technically going from unit of the hospital to another is not a discharge it's a transfer.  The only time it's considered a discharge is going from inpatient care to hospice or rehab.  In your doctor's case since it's the same admission you will still use the subsequent visit codes for all visits after the initial until the actual discharge from the facility.

Use the admit/discharge same day codes (99234-99236) when a patient is actually admitted as and inpatient or to observation and then is discharged the same day (say admitted at 6:00 am and idscharged at 3:00 pm same day)


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## ABridgman (Sep 3, 2013)

So...a discharge from, say the icu and an admit to the psych ward...on the same day...

Would that just be a 99233?  Or would I use the 99236?


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## dclark7 (Sep 3, 2013)

99233 provided the documentationb supports this level


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