Wiki Same Day Admit/Discharge Coding

[psiebken]

Use of codes 99234-99236:
Patient admitted (per facility): 4:28 A.M.
Patient discharged (per facility): 1:15 P.M.
Total time in hospital: approximately 8 3/4 hours
Provider dictated H&P: 5:36 A.M.
Provider dictated Discharge Summary: 11:33 A.M. (slightly less than 6 hours between provider admit and disharge notes)

Our question is: in order to be able to use the 99234-99236 codes, are we to follow the admit and discharge times of the facility, or the H&P and Discharge Summary times? We have looked at CMS Publication 100-04; Chapter 12, 30.6.8, and but it is unclear as to how we should calculate the times to support 99234-99236.

Our fiscal intermediary (Noridian) referred me to http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c04.pdf.

My co-workers are split about whether we should go by the facility admit and discharge times or the times between when a provider saw the for the H&P and the time when the patient was seen again for the Discharge.

 

[Missy13]

In order for you to use 99234-99236 you are to follow the "date" of service.
The patient has to be admited and discharges on the same calendar date.
If the patient is admitted on January 1st at 4:28 AM, and discharged on that same date January 1st 1:15 PM, then you can use one of these codes depending of the level of care doctor provided.

It has nothing to do with what time the documentation was dictated, or how many hours patient spent in the hospital that day. It's for the same date of service "calendar date".
Read the guidelines in the CPT book for that section it explains it in the first sentence.

Hope this was helpful