Cardiology Coding Alert

Question: My cardiologist admitted a patient and performed a procedure on the 23rd of the month. On the 24th he reviewed the patient, went over everything, and discharged the patient. Am I  correct that I can charge for the hospital discharge (such as 99238) by the same doctor for a patient during the global period of the procedure?

Alaska Subscriber

Answer: Unfortunately, you may be incorrect. If you are in a 90-day global period of a procedure (as would be the case with pacemaker and defibrillator surgeries) or if the discharge is on the same day as the surgery, you cannot separately report the discharge codes: 99238-99239 (Hospital discharge day management ...). In these cases the discharge is included in the procedure coding and global period.

Exception: With certain cardiology procedures that have a zero-day global if the patient is admitted to the hospital after surgery and then discharged the next day or days later, you can then bill for the discharge services. Remember to also bill hospital encounter codes if a patient is admitted to the hospital after a zero-day global procedure and stays a few days.