Oncology & Hematology Coding Alert

Question: A physician discharges a patient from the hospital and admits her to the hospital's hospice program in the same building. He visits the patient at the hospice. What codes should we use?

Georgia Subscriber

Answer: If the hospice is independent of the hospital and provides inpatient care, there is no code for the physician to bill, with the exception of the discharge code (99238-99239). There are no E/M services for hospice, except for the non-face-to-face case management codes (99377-99378).

If the patient is simply transferred from acute care to a palliative care unit within the hospital, you should determine if the oncologist will be providing acute care or if the patient requires nursing care only. If the patient is transferred from acute care to hospice care, the physician should bill only for a follow-up hospital visit (99231-99233). If the patient is discharged from the hospital and admitted to a nursing facility, then you should code the hospital discharge with 99238-99239 and the nursing home admit with 99301-99303 based on the physician documentation.