Podiatry Coding & Billing Alert

Question: A podiatrist saw an inpatient, and performed discharge services. However, the hospital discharged the patient only the next day. It's not clear to me if a code from the hospital subsequent care series (99231-99233) should be reported for the actual day of discharge or the day when the physician rendered the discharge services. Which is which?

Kentucky Subscriber

Answer: For the date when the attending physician rendered the discharge services, you should use the hospital discharge codes 99238 (Hospital discharge day management; 30 minutes or less) and 99239 (Hospital discharge day management; more than 30 minutes). Make sure, however, that the date of discharge is different from the date of admission. These service codes also include final examination of the patient, discussion of the hospital stay, instructions for continuing care to all relevant caregivers, as well as preparation of discharge records, prescriptions, and referral forms.

Don't forget: You should base your reporting 99238 and 99239 from the total time spent by the attending physician for final hospital discharge of the patient, and not include key components i.e., history, exam, and medical decision making.

You should add up the "total time," even if the time is not continuous.

Sometimes, the physician would write her discharge orders on a different date. Nevertheless, she must document the specific date the hospital discharge services were rendered to the patient. For instance, you should not report a subsequent hospital care visit (e.g., 99232) a day after reporting patient discharge services (e.g., 99238) because the hospital discharge codes should only be used to report the final hospital discharge of the patient.