Internal Medicine Coding Alert

Question: How should we bill for a nursing home discharge after the patient has died?

New Mexico Subscriber

Answer: The key to coding a discharge is knowing if your internist saw the patient on the day the patient died. The Medicare Carriers Manual does not directly address the nursing-home discharge code requirements. But Medicare does require that the physician provide "face-to-face" contact with the patient on the day of billing either 99315 (Nursing facility discharge day management; 30 minutes or less) or 99316 (...more than 30 minutes). For example, that means your physician would need to be present to pronounce the patient's death for him to bill for discharge services.
 
If your physician did not attend to the patient "face-to-face" the day the patient died, you should probably not bill for a discharge.