Question: A patient leaves a nursing facility (NF) against medical advice (AMA). Can an internist charge a discharge service? Codify Member Answer: Check if the internist provided a face-to-face service before the patient left the NF. If the internist saw the patient on the same day prior to his or her departure from the nursing facility, you should bill subsequent nursing facility care (99307-99310). Since the internist did not discharge the patient, no discharge management should have occurred. Therefore, NF discharge service codes (99315-99316) would not appropriately describe the care provided. If the patient left AMA without the internist evaluating the patient the same calendar day, the internist did not render any face-to-face services that day. In this case, you should not report any physician services for the final day in which the patient left the NF.