Wiki Discharge Management

[tammymills97]

In need of some help with 99238 and 99239.

I have a provider that is stating codes 99238 and 99239 are based only on the time he spends face-to-face with the patient and cannot include the time spent away from the patient preparing paperwork and writing orders. We showed him the CPT book and the requirements of the code and his statement is that the CPT is only an advisory to Medicare. He is citing as his reference Chapter 12 of the CMS Claims Processing Manual that states it is a face-to-face visit. He states that as this states nothing about the time spent preparing other documents and speaking with other providers/caretakers it cannot be included in the time of discharge and only the time spent face-to-face with the patient can be counted. So far I have been unable to find anything from NGS, our MAC, in regards to this and any help would be greatly appreciated.

Thanks!!

 

[awagner]

hope this helps

When I went to our local Medicare carrier (WPS) site, this is what it says about what's included in the discharge day management.

"Discharge Day Management Services

Hospital discharge day management codes 99238 and 99239 include, as appropriate, final examination of the patient, discussion of the hospital stay, even if the time spent by the physician on the date is not continuous, discharge records, prescriptions and referral forms. As a reminder, discharge management must include documentation of a face-to-face evaluation and management (E/M) service between the attending physician and the patient."

Hope that helps!!!

AWagner CPC