Wiki Discharge question

[jdibble]

Can someone help with this issue -

- Our hospitalists saw the patient on 12/12/09 and discharged the patient. We billed the discharge and it paid. However, the patient did not leave the hospital on 12/12/09 as her BP elevated and it was decided to keep her overnight. She was eventually seen by the same doc on 12/13/09 who decided she could now be discharged. He billed a 99231 for 12/13/09 and also another discharge code. Now, I know we need to remove the discharge, but can we bill for the 99231. The insurance is denying both of these - if is possible to bill a subsequent visit on a day after a discharge has been billed?

Thanks,

Jodi Dibble, CPC

 

[jdibble]

How should this be coded?

Hoping someone can answer this for me - I am still stumped if this visit can be billed and paid if it is after the discharge date? I need to respond to the billing company's inquiry on this as they are making more of a mess now by rebilling the charges they think should be paid without waiting for my response. I want to make sure they bill correctly, so any answers would be helpful!

Thanks!

 

[LindaEV]

According to our Medicare carrier, WPS, you bill the discharge code for the day you do the actual discarge work.
Here is an excerpt from their website:

Q3. I provided the final discharge instructions on Tuesday. However, the patient did not leave the hospital until Wednesday. I did see the patient on Wednesday. How do I bill for this?
A3. Report the discharge day management service for the date of the actual visit, even if the patient is discharged from the facility on a different calendar date. The service on Wednesday is a subsequent hospital visit code when the documentation supports the code and the level of service and medical necessity of the service.

http://www.wpsmedicare.com/j5macpartb/training/resources/provider_types/2009_0629_emfaqdischarge.shtml


So according to them. D/C code on the 12th, and a subsequent visit on the 13th.

Now, this may change according to payer...but if they don't have a policy, they will usually accept Medicares.

 

[jdibble]

Thanks Linda for you help. The insurance is denying the subsequent visit on the day after discharge but the billing also billed for another discharge for that same day which is also denying as already charged. I will have them correct and see if they can appeal the subsequent visit.

Thanks again!