Cardiology Coding Alert

You Be the Coder:

Billing for a Patient Who Discharges AMA

Published on Fri Dec 01, 2000

Question: One of our physicians admitted a patient to observation from the emergency department. The next day the patient signed himself out against medical advice (AMA). A different physician in our practice dictated a discharge summary. How should I bill this?

Pennsylvania Subscriber

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Answer: Discharge summary requirements are not stringent, but face-to-face contact between the patient and the discharging physician is one of the criteria. If the physician saw the patient before the patient discharged himself, observation discharge code 99217 can be billed, says Sandy Fuller, CPC, a practice coder with Abilene Cardiology Consultants, a 13-physician practice in Abilene, Texas. If the physician never saw the patient and was dictating a discharge to fulfill a hospital requirement, 99217 should not be charged.

Nobody pays you for paperwork alone, Fuller says. If the physician didnt have face-to-face contact with the patient, no care was provided and no discharge should be billed.