Wiki Inpatient and discharge

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DSchrlau

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What would be the appropriate way to code a patient was admitted to the hospital by my doctor at 830 pm and by midnight was taking a turn for the worse and needed to be transfered out to a different hospital my doctor did a discharge for patient and she was transfered out by 230 am. What would be the correct way to code this and is there any references out there that would support what to code? I know the the CMS must be at least 8 hours but that is when the patient is discharged home? And with it going over 2 calendar days I am just confused?
 
DSchrlau said:
What would be the appropriate way to code a patient was admitted to the hospital by my doctor at 830 pm and by midnight was taking a turn for the worse and needed to be transfered out to a different hospital my doctor did a discharge for patient and she was transfered out by 230 am. What would be the correct way to code this and is there any references out there that would support what to code? I know the the CMS must be at least 8 hours but that is when the patient is discharged home? And with it going over 2 calendar days I am just confused?
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Hi. A few questions, if I may. Under what status was your patient admitted as (Observation or Inpatient)? Did your physician see the patient face-to-face before midnight? Did he or she also see the patient past midnight prior to discharge/transfer?

Thanks,
Jettman
 
The patient was admitted as an Inpatient. The physician was face-to-face before midnight and she had seen the patient prior to transfer after midnight.
 
DSchrlau said:
The patient was admitted as an Inpatient. The physician was face-to-face before midnight and she had seen the patient prior to transfer after midnight.
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Thanks. Since the patient is an inpatient, I would code the before midnight encounter from the Inital Hospital Care codes 99221 - 99223. The after midnight encounter I would report as 99238 or 99239 (using the next calendar day as the date of service), as appropriate.

Hope this helps,
Jettman
 
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