Wiki Time for inpatient discharges

[MnTwins29]

I am seeing a trend our hospitlaists are documenting that I am not comfortable with. I am seeing the statement "more than 30 minutes" in many discharge summaries in order to be able to use 99239 for their discharge services. I would rather see something like "38 minutes" or something more precise, but maybe I am just too picky. What do you think? Is this sufficient or should I educate them on more specific documentation?

 

[tgomez12]

This is the only Thread I see about coding for Discharge services and I was wondering if you could help me with a question. I have a senerio where Dr. A admits patient and performes an operation that has a 90 day global. Two days later Dr. B does a discharge on the patient. Can the discharge be billed? If not why, is it because of the global period or is it because Dr. B was not the admitting provider?

Thank you for your help.

Tiffany Gomez CPC, CASCC

 

[mhstrauss]

I am seeing a trend our hospitlaists are documenting that I am not comfortable with. I am seeing the statement "more than 30 minutes" in many discharge summaries in order to be able to use 99239 for their discharge services. I would rather see something like "38 minutes" or something more precise, but maybe I am just too picky. What do you think? Is this sufficient or should I educate them on more specific documentation?

Lance,

My opinion is that they need to specifically state how much time was spent, and have enough documentation to justify the higher level code.
Not sure who your MAC is, but this is from WPS (emphasis added by me):

"Physicians must use the total duration of time spent in order to select the code that reflects hospital discharge day management services provided for Medicare beneficiaries. For this reason, the provider must clearly indicate in the patient's medical record the total duration of time spent when performing these services."

Here is the link to the page it came from:

http://www.wpsmedicare.com/part_b/departments/cert/2010_0329_time.shtml

Hope this helps!

 

[mhstrauss]

This is the only Thread I see about coding for Discharge services and I was wondering if you could help me with a question. I have a senerio where Dr. A admits patient and performes an operation that has a 90 day global. Two days later Dr. B does a discharge on the patient. Can the discharge be billed? If not why, is it because of the global period or is it because Dr. B was not the admitting provider?

Thank you for your help.

Tiffany Gomez CPC, CASCC

Tiffany,

Are Dr.'s A and B from the same organization and same specialty?

 

[MnTwins29]

Thank you, Meghan. Our MAC is NGS, so I will check there, but this is a good reference for use in my next education session with them. As for the other question - would it make any difference whether they were in the same group? I would think that if the visit to discharge the patient was related to the surgery, it would be part of the surgical package.

 

[mhstrauss]

As for the other question - would it make any difference whether they were in the same group? I would think that if the visit to discharge the patient was related to the surgery, it would be part of the surgical package.

I agree with you on this. When "partners" are covering for each other, billing is treated as if the patient's original provider was performing the service...if the service would be considered global for Dr. A, then it is also global for Dr. B. Same applies to any follow-up appts for the remainder of the global period.