Primary Care Coding Alert

Question: A patient leaves a nursing facility (NF) against medical advice (AMA). Can the FP charge a discharge service?

Codify Member

Answer: Check if the FP provided a face-to-face service before the patient left the NF. If the physician 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 FP 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 physician evaluating the patient the same calendar day, the FP 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.